BEUDAMED
    FDA Adverse Event Death Summary report: N

    SERVO VENTILATOR

    MDR report key: 29555 · Received January 30, 1996

    Report

    Report Number
    MW1008198
    Event Type
    Death
    Date Received
    January 30, 1996
    Date of Event
    December 13, 1995
    Report Date
    December 19, 1995
    Manufacturer
    ELECTROMEDICAL GROUP SIEMENS MEDICAL SYSTEMS, INC.
    Product Code
    CBK
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    HIGH PEAK PRESSURE ALARM GOING OFF ON VENTILATOR. PT CHECKED AND SUCTIONED, ALARM CONTINUED. VENT CHECKED AND TUBE THAT ACTIVATED EXHALATION VALVE FOUND TO BE DISCONNECTED, THIS TUBING IS BEHIND ACCESS COVER AND NOT IN PLAIN VIEW.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SERVO VENTILATOR VENTILATOR CBK ELECTROMEDICAL GROUP SIEMENS MEDICAL SYSTEMS, INC. 900C

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Death