BEUDAMED
    FDA Adverse Event Death Summary report: N

    NONE

    MDR report key: 2171894 · Received March 28, 2006

    Report

    Report Number
    2171894
    Event Type
    Death
    Date Received
    March 28, 2006
    Date of Event
    January 25, 2006
    Report Date
    March 14, 2006
    Product Code
    MKJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT WAS FOUND IN RESPIRATORY ARREST WITH ASYSTOLE AT APPROX 0635. THE LIFE PAK 20 USED IN THIS EVENT FAILED TO CAPTURE THE EVENT. LP20 - SERIAL# (B)(4). PT EXPIRED AT APPROX 0735.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NONE MKJ

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Death