BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 3817225 · Received April 28, 2014

    Report

    Report Number
    3817225
    Event Type
    Malfunction
    Date Received
    April 28, 2014
    Date of Event
    April 3, 2014
    Report Date
    April 28, 2014
    Manufacturer
    VITAL SIGNS , INC.
    Product Code
    CAH
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    ME, US

    Narratives

    Description of Event or Problem · 1

    SMALL BLUE OCCLUSION CAP IS CRACKED, AND/OR DOES NOT RETAIN ITSELF ONTO MALE FITTING, AND/OR HAS BEEN MISSING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    254196 * FILTER, BACTERIAL, BREATHING-CIRCUIT CAH VITAL SIGNS , INC. 155518 7982324

    Patients

    Seq Age Sex Outcome Treatment
    1 *