FDA Adverse Event Death Summary report: N

COMPONENT MONITORING SYSTEM

MDR report key: 274086 · Received April 12, 2000

Report

Report Number
1218950-2000-00013
Event Type
Death
Date Received
April 12, 2000
Date of Event
March 11, 2000
Report Date
March 14, 2000
Manufacturer
AGILENT TECHNOLOGIES, INC.
Product Code
DPS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Description of Event or Problem · 1

THE FOLLOWING EVENT WAS REPORTED TO MFR: THE NURSE RETURNED FROM BREAK AND SAW ONLY PACER SPIKES ON THE MONITOR. NO ALARMS WERE SOUNDING. THE PT WAS RESUSCITATED AND THE CT SCAN SHOWED NO BRAIN ACTIVITY. SUPPORT WAS WITHDRAWN. THE PT EXPIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COMPONENT MONITORING SYSTEM MONITORING SYSTEM DPS AGILENT TECHNOLOGIES, INC. M1175A NA

Patients

Seq Age Sex Outcome Treatment
1 68 YR Death