FDA Adverse Event Malfunction Summary report: N

BSZ

MDR report key: 3793660 · Received April 7, 2014

Report

Report Number
3010587095-2014-00005
Event Type
Malfunction
Date Received
April 7, 2014
Report Date
March 4, 2014
Manufacturer
PHILIPS ANESTHESIA CARE
Product Code
BSZ
PMA / PMN Number
K122063
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MY
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). NOTE THAT MANUAL DELIVERY IS AVAILABLE IF NEEDED, SUCH AS IF THERE WOULD BE NO DISPLAY; MANUAL DELIVERY IS A NORMAL PART OF THE USE FOR EVERY PATIENT; AND THE IFU FOR THIS DEVICE SPECIFIES THAT THERE BE AN ATTENDANT CLINICIAN. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

A USER REPORTED THAT ONE OCCASION WHERE THE MACHINE SCREEN SHUT DOWN AUTOMATICALLY DURING OPERATION. THERE WAS NO ADVERSE IMPACT ON THE PATIENT. THIS PROBLEM OCCURRED DURING THE FIRST USES OF THIS DEVICE AND HAS NOT RECURRED SINCE THE USERS HAVE BECOME MORE EXPERIENCED. THE DEVICE REMAINS IN USE AND HAS NEEDED NO REPAIR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
209888 BSZ DAMECA, GAS-MACHINE, ANESTHESIA BSZ PHILIPS ANESTHESIA CARE 866205

Patients

Seq Age Sex Outcome Treatment
1