BEUDAMED
    FDA Adverse Event Death Summary report: N

    DRAGER EVITA

    MDR report key: 225945 · Received June 2, 1999

    Report

    Report Number
    MW1016442
    Event Type
    Death
    Date Received
    June 2, 1999
    Date of Event
    April 23, 1999
    Report Date
    May 24, 1999
    Manufacturer
    DRAGER, INC.
    Product Code
    CBK
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    ON 4/23/99: PT WITH CARDIOGENIC SHOCK ADMITTED THROUGH EMERGENCY. INTUBATED, CODED, RESUSCITATED, TO ICU. NURSE IN ROOM NOTED VENTILATOR NOT GIVING BREATHS. PT REMOVED FROM VENTILATOR AND BAGGED. NO ALARMS NOTED, NO AIR NOTED FROM VENTILATOR TUBING (NOT DELIVERING BREATHS). PT CODED, RESUSCITATION 1 HR UNSUCCESSFUL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DRAGER EVITA VENTILATOR CBK DRAGER, INC. E4 *

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Death