FDA Adverse Event
Malfunction
Summary report: N
ACUITY CENTRAL MONITORING
MDR report key: 2251655
·
Received August 31, 2011
Report
- Report Number
- 3023750-2011-00078
- Event Type
- Malfunction
- Date Received
- August 31, 2011
- Date of Event
- August 10, 2011
- Report Date
- August 10, 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 THEY HAD A SONY DISPLAY THAT WENT BLANK AND NOW IS NOT POWERING UP. THIS RESULTED IN A TEMPORARY INABILITY TO MONITOR PTS CENTRALLY UNTIL THE CUSTOMER REPLACED THE MONITOR. THERE WAS NO REPORT OF ANY PT HARM AS A RESULT OF THE REPORTED EVENTS.
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 |