FDA Adverse Event Malfunction Summary report: N

PROPAQ CS 246

MDR report key: 2151374 · Received June 8, 2011

Report

Report Number
3023750-2011-00048
Event Type
Malfunction
Date Received
June 8, 2011
Date of Event
May 9, 2011
Report Date
May 9, 2011
Manufacturer
WELCH ALLYN PROTOCOL, INC.
Product Code
DRT
PMA / PMN Number
K012451
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE EVALUATION IS NOT YET COMPLETE. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.

Description of Event or Problem · 1

WELCH ALLYN RECEIVED A COMPLAINT WHERE A PROPAQ CS BEDSIDE MONITOR'S DISPLAY LOCKED-UP WHILE MONITORING A PT. THE COMPLAINANT ALSO INDICATED THAT THE PROPAQ CS MONITOR DID NOT PROVIDE THE CLINICIAN ANY AUDIBLE OR VISUAL ALARMS. THERE WAS NO REPORT OF ANY PT HARM AS A RESULT OF THE REPORTED EVENT. NOTE: THE CUSTOMER DID NOT PROVIDE ANY PT INFO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROPAQ CS 246 DRT WELCH ALLYN PROTOCOL, INC. PROPAQ 246 CS

Patients

Seq Age Sex Outcome Treatment
1