BEUDAMED
    FDA Adverse Event Other Summary report: N

    THUMPER

    MDR report key: 357547 · Received October 20, 2001

    Report

    Report Number
    1821850-2001-00010
    Event Type
    Other
    Date Received
    October 20, 2001
    Date of Event
    March 11, 2001
    Report Date
    October 18, 2001
    Manufacturer
    MICHIGAN INSTRUMENTS, INC.
    Product Code
    DRM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    EMERGENCY MEDICAL TECHNICIAN

    Narratives

    Description of Event or Problem · 1

    THE DEVICE WAS BEING USED TO PROVIDE CARDIOPULMONARY RESUSCITATION ON A PT. WHILE MOVING THE PT OUT OF THE HOUSE, THE OXYGEN HOSE GOT CAUGHT ON A DOOR. THE CREW PULLED ON IT AND BROKE THE OXYGEN CONNECTOR OFF FROM THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    47232 THUMPER CARDIOPULMONARY RESUSCITATOR DRM MICHIGAN INSTRUMENTS, INC. 1007 *

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR