FDA Adverse Event Malfunction Summary report: N

ACUITY CENTRAL MONITORING

MDR report key: 2182092 · Received June 23, 2011

Report

Report Number
3023750-2011-00060
Event Type
Malfunction
Date Received
June 23, 2011
Date of Event
May 24, 2011
Report Date
May 24, 2011
Manufacturer
WELCH ALLYN PROTOCOL, INC.
Product Code
DSI
PMA / PMN Number
K052160
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT HE NOTICED MOST OF THE ACCESS POINTS IN THE AREA WERE NOT COMMUNICATING WHEN HE WAS WALKING AROUND THE FLOOR WITH A MICROPAQ DEVICE. THIS RESULTED IN A LOSS OF CENTRALIZED PATIENT MONITORING. THERE WAS NO REPORT OF ANY PATIENT HARM AS A RESULT OF THE REPORTED EVENT. THE CUSTOMER DID NOT PROVIDE ANY PATIENT INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACUITY CENTRAL MONITORING DSI WELCH ALLYN PROTOCOL, INC. ACUITY SW 7.10.01

Patients

Seq Age Sex Outcome Treatment
1