BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFE CARE PORTABLE VENT

    MDR report key: 269263 · Received March 13, 2000

    Report

    Report Number
    269263
    Event Type
    Injury
    Date Received
    March 13, 2000
    Date of Event
    March 4, 2000
    Report Date
    March 10, 2000
    Manufacturer
    MEDIQ PRN LIFE SUPPORT SERVICES
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    NEW LEASED VENTILATORS WERE BEING IMPLEMENTED TO REPLACE PREVIOUS VENDOR. ALARM SOUNDED WITHIN 5 MIN. APPEARED TO BE RELATED TO O2. RESIDENT IMMEDIATELY REPLACED ON PREVIOUS VENTILATOR. NO HARM TO PT. VENT READING A5-ALARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFE CARE PORTABLE VENT PORTABLE VENTILATOR CBK MEDIQ PRN LIFE SUPPORT SERVICES PLV102 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Required Intervention