BEUDAMED
    FDA Adverse Event Death Summary report: N

    PRECISION

    MDR report key: 371461 · Received January 16, 2002

    Report

    Report Number
    371461
    Event Type
    Death
    Date Received
    January 16, 2002
    Date of Event
    January 15, 2002
    Report Date
    January 16, 2002
    Manufacturer
    PRECISION MEDICAL INC
    Product Code
    CAX
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CT, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    OXYGEN FLOW METER USED WITH ADAPTER/CONNECTOR. ONE OF TWO PRONGS BROKEN OFF CONNECTOR, ALLOWING INSERTION INTO NITROUS OXIDE PORT. PT WAS ON VENTILATOR DURING CODE SITUATION OCCURRING DURING CARDIAC CATH, AND RECEIVED NITROUS OXIDE INSTEAD OF OXYGEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRECISION OXYGEN FLOW METER AND CONNECTOR CAX PRECISION MEDICAL INC 1MFA4001-FLOWMETER *

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Death