FDA Adverse Event Malfunction Summary report: N

SPACELABS MULTIGAS MODULE

MDR report key: 3211572 · Received July 8, 2013

Report

Report Number
3023361-2013-00029
Event Type
Malfunction
Date Received
July 8, 2013
Date of Event
April 3, 2013
Report Date
April 24, 2013
Manufacturer
SPACELABS MEDICAL INC.
Product Code
CBR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 1

NO ONE WAS INJURED AS A RESULT OF THIS EVENT. SPACELABS IS EVALUATING THIS EVENT AND WILL FILE A F/U REPORT WHEN OUR EVAL IS CONCLUDED.

Description of Event or Problem · 1

THE CUSTOMER HAS A 92518 GAS MODULE CONNECTED TO XPREZZON MONITOR. THE CUSTOMER REPORTED, "THE GAS PARAMETER BEGAN TO FLICKER AND BLINK, THEN FINALLY LOST COMMUNICATION."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
312128 SPACELABS MULTIGAS MODULE CBR: MULTIGAS ANALYZER CBR SPACELABS MEDICAL INC. 92518

Patients

Seq Age Sex Outcome Treatment
1 Unknown (B)(4)