FDA Adverse Event Death Summary report: N

MC10 PULSE OXIMETRY CABLE

MDR report key: 337342 · Received June 15, 2001

Report

Report Number
8043756-2001-00002
Event Type
Death
Date Received
June 15, 2001
Report Date
June 15, 2001
Manufacturer
NELLCOR DE MEXICO, S.A. DE C.V.
Product Code
DQA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

ON 5/16/2001, A FACILITY REPORTED THAT IN 2000 A NELLCOR PULSE OXIMETER ON PT ALARMED (DISPLAYING A "SENSOR DISCONNECT MESSAGE"). THE FACILITY REPORTEDLY IGNORED THE ALARM. THE FACILITY ALSO REPORTED THAT THE PT DESATURATED, SUFFERED ANOXIA AND SUBSEQUENTLY DIED. THIS INFO WAS REPORTED TO A MALLINCKRODT EMPLOYEE DURING A VISIT TO THE FACILITY AND A DISCUSSION REGARDING DIFFICULTIES REPORTED BY THE FACILITY CONCERNING LOOSE MC-10 PULSE OXIMETER CABLES (WHICH CONNECT THE SENSOR TO THE MONITOR). THE LOOSE CABLES RESULTED IN FREQUENT MONITOR ALARMS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
27299 MC10 PULSE OXIMETRY CABLE PULSE OXIMETRY CABLE DQA NELLCOR DE MEXICO, S.A. DE C.V. MC10 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Death 1. NPB 290| 2. OXINET II SYSTEM.