BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GAS MODULE III

    MDR report key: 3091495 · Received April 30, 2013

    Report

    Report Number
    2221819-2013-00464
    Event Type
    Malfunction
    Date Received
    April 30, 2013
    Date of Event
    December 14, 2012
    Report Date
    April 30, 2013
    Manufacturer
    MINDRAY DS USA, INC.
    Product Code
    BSZ
    PMA / PMN Number
    062754
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    MINDRAY SERVICE REPRESENTATIVES INSTALLED AN EXCHANGE BENCH AND CALIBRATED THE GAS MODULE III TO SPECIFICATIONS.

    Description of Event or Problem · 1

    CUSTOMER REPORTED AN ISSUE WITH THE GAS MODULE III WHICH MAY HAVE RESULTED IN A LOSS OF GAS MONITORING. NO PATIENT INJURY WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    186410 GAS MODULE III GAS MONITOR BSZ MINDRAY DS USA, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1