BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IMPACT INSTRUMENTATION, INC.

    MDR report key: 234956 · Received August 6, 1999

    Report

    Report Number
    234956
    Event Type
    Injury
    Date Received
    August 6, 1999
    Date of Event
    July 1, 1999
    Report Date
    August 6, 1999
    Manufacturer
    IMPACT INSTRUMENTATION
    Product Code
    GCJ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    PARAMEDIC

    Narratives

    Description of Event or Problem · 1

    INTUBATED PT BEING TRANSPORTED FROM ONE HOSPITAL TO ANOTHER. PORTABLE VENTILATOR MALFUNCTIONED AND DISCONTINUED OPERATING WHILE EN ROUTE. OTHER EQUIPMENT WAS AVAILABLE TO VENTILATE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IMPACT INSTRUMENTATION, INC. UNI-VENT EAGLE PORTABLE VENTILATOR GCJ IMPACT INSTRUMENTATION 754 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Required Intervention