BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IMPACT INSTRUMENTATION, INC

    MDR report key: 346427 · Received August 9, 2001

    Report

    Report Number
    346427
    Event Type
    Injury
    Date Received
    August 9, 2001
    Date of Event
    July 25, 2001
    Report Date
    August 8, 2001
    Manufacturer
    IMPACT INSTRUMENTATION, INC
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    PARAMEDIC

    Narratives

    Description of Event or Problem · 1

    PT BEING TRANSPORTED ON PORTABLE VENTILATOR. LOW BATTERY INDICATOR CAME ON, VENTILATOR WAS PLUGGED INTO AC POWER SOURCE WITH ACCOMPANYING CHARGER. CHARGER FAILED TO POWER VENTILATOR, AND VENTILATOR SHUT OFF. ALTERNATE EQUIPMENT AVAILABLE AND IMMEDIATELY IMPLEMENTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36032 IMPACT INSTRUMENTATION, INC UNIVERSAL AC POWER SUPPLY CBK IMPACT INSTRUMENTATION, INC 754 *

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Life Threatening