FDA Adverse Event Summary report: N

CO2 TANK

MDR report key: 3624023 · Received January 22, 2014

Report

Report Number
3624023
Date Received
January 22, 2014
Date of Event
January 22, 2014
Report Date
January 22, 2014
Manufacturer
OHIO MEDICAL
Product Code
ECX
Report Source
User Facility report
Reporter Location
IL, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

POST-OP PATIENT CONNECTED TO PORTABLE MEDICAL GAS TANK FOR TRANSPORT. OXYGEN SATURATION DROPPED. PATIENT CARDIAC ARRESTED. FOUND THAT PT WAS CONNECTED TO A CO2 TANK. PATIENT WAS SUCCESSFULLY RESUSCITATED. THE CO2 TANK HAD A GREEN PLASTIC ADAPTER (CONE SHAPED ADAPTER) ON THE REGULATOR NOZZLE. GREEN ADAPTORS INDICATE OXYGEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
52557 CO2 TANK CYLINDER, COMPRESSED GAS, AND VALVE ECX OHIO MEDICAL * *
52558 GREEN REGULATOR REGULATOR, PRESSURE, GAS CYLINDER CAN WESTERN MEDICAL * *

Patients

Seq Age Sex Outcome Treatment
1 80 YR WORD OHIO STAMPED INTO THE METAL. TANK| REGULATOR MFG: WESTERN MEDICAL, WESTLAKE, OH | RADNOR, PA.| CO2 TANK MFG: TANK MFG NAME UNKNOWN. TANK HAS THE| NO OTHER THERAPIES| DISTRIBUTOR: AIRGAS PURITAN MEDICAL/ AIRGAS USA,