BEUDAMED
    FDA Adverse Event Death Summary report: N

    DYNASCOPE D5-3300 TELEMETRY SYSTEM ETR

    MDR report key: 332986 · Received April 19, 2001

    Report

    Report Number
    9611031-2001-00001
    Event Type
    Death
    Date Received
    April 19, 2001
    Date of Event
    April 9, 2001
    Report Date
    April 19, 2001
    Manufacturer
    FUKUDA DENSHI CO. LTD
    Product Code
    DSI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ON APRIL 19TH 2001 THE HOSPITAL MAILED A COPY OF THEIR MEDWATCH FORM, (RECEIVED ON 4/24/01). DESCRIBED EVENT WAS, PATIENT FOUND UNRESPONSIVE. FULL CODE CALLED. RESUSCITATION EFFORT UNSUCCESSFUL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    18488 DYNASCOPE D5-3300 TELEMETRY SYSTEM ETR TELEMETRY CENTRAL STATION DSI FUKUDA DENSHI CO. LTD DS-3300 *

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Death