BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANESTHETIC GAS MODULE

    MDR report key: 242973 · Received September 30, 1999

    Report

    Report Number
    1218950-1999-00127
    Event Type
    Malfunction
    Date Received
    September 30, 1999
    Report Date
    August 30, 1999
    Manufacturer
    AGILENT TECHNOLOGIES, INC.
    Product Code
    CBQ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THEY HAVE HAD INTERMITTENT PROBLEMS WITH THIS DEVICE. THEY REPORTED THAT VALUES HAVE DISAPPEARED FROM TIME TO TIME, WHITE SCREEN, A LOT OF MOISTURE IN THE DEVICE, AND NO WATER TRAP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANESTHETIC GAS MODULE AGM CBQ AGILENT TECHNOLOGIES, INC. M1026A NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA