BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    IMPACT EAGLE 752

    MDR report key: 341376 · Received June 27, 2001

    Report

    Report Number
    341376
    Event Type
    Malfunction
    Date Received
    June 27, 2001
    Date of Event
    June 15, 2001
    Report Date
    June 22, 2001
    Manufacturer
    IMPACT INSTRUMENTATION
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IMPACT EAGLE TRANSPORT VENTILATOR FAILED. DURING CRITICAL CARE TRANSPORT TO RE-HAB FACILITY. ERROR CODE 02, NO GAS, COMPRESSOR FAILURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    29318 IMPACT EAGLE 752 VENTILATOR CBK IMPACT INSTRUMENTATION 754 *

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Other