FDA Adverse Event Death Summary report: N

GLIDESCOPE

MDR report key: 3216727 · Received July 5, 2013

Report

Report Number
9615393-2013-00157
Event Type
Death
Date Received
July 5, 2013
Date of Event
June 6, 2013
Report Date
July 5, 2013
Manufacturer
VERATHON MEDICAL (CANADA) ULC.
Product Code
CCW
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Description of Event or Problem · 1

THE CUSTOMER CONTACTED VERATHON INC. INDICATING THAT A GLIDESCOPE VIDEO BATON 1-2 AND THE PGVL MONITOR WAS USE TO ATTEMPT INTUBATION DURING A CARDIAC ARREST IN A CHILD AT THE (B)(6) HOSPITAL ON (B)(6) 2013. THE PT DIED. THE MONITOR FAILED TO DELIVER A SATISFACTORY IMAGE WHEN TURNED ON. THE (B)(6), SAID THAT THE FAILED GLIDESCOPE IMAGE WAS NOT CAUSAL OF THE ADVERSE PT OUTCOME AND ITS NORMAL USE WOULD NOT HAVE CHANGED THE OUTCOME. THE USER SETTINGS FOR THE MONITOR WERE SET AT LOW BRIGHTNESS, RESULTING IN A DARK IMAGE TO BE DISPLAYED. (B)(6) INDICATED THAT AT SOME TIME PRIOR TO THE INCIDENT, THE SETTINGS FOR THE DEVICE WERE SET TO A VERY LOW LEVEL. THESE SETTINGS WERE SELECTED AND SAVED BY THE PREVIOUS USER OF THE DEVICE AT THE FACILITY. THE DEVICE WAS TESTED BY BOTH THE CUSTOMER'S INVESTIGATION TEAM (B)(6) AND VERATHON MEDICAL (B)(4). BOTH INVESTIGATIONS DID NOT IDENTIFY A DEVICE MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
308296 GLIDESCOPE VIDEO LARYNGOSCOPE CCW VERATHON MEDICAL (CANADA) ULC. 0231-0003

Patients

Seq Age Sex Outcome Treatment
1 Death