BEUDAMED
    FDA Adverse Event Death Summary report: N

    AIRLIFE

    MDR report key: 365018 · Received December 6, 2001

    Report

    Report Number
    MW1023565
    Event Type
    Death
    Date Received
    December 6, 2001
    Date of Event
    December 1, 2001
    Report Date
    December 6, 2001
    Manufacturer
    ALLEGIANCE
    Product Code
    BTM
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT ADMITTED WITH PNEUMONIA, BUT HAS HISTORY OF MYOTONIC DYSTROPHY WHILE ATTEMPTING TO VENT. PT AMBUBAG FAILED. PT CODED AND EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    54945 AIRLIFE AMBU-BAG BTM ALLEGIANCE * Y7E0399

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR Death