FDA Adverse Event Malfunction Summary report: N

KION

MDR report key: 3832521 · Received March 17, 2014

Report

Report Number
8010042-2014-00093
Event Type
Malfunction
Date Received
March 17, 2014
Date of Event
February 28, 2014
Report Date
February 28, 2014
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
BSZ
PMA / PMN Number
K024213
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

A COMPANY FIELD SERVICE ENGINEER HAS BEEN ON SITE AND HAS STARTED THE INVESTIGATION. A SUPPLEMENTAL REPORT WILL BE PROVIDED WHEN THE INVESTIGATION HAS BEEN FINALIZED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE ON A PATIENT, THE ANESTHESIA WORKSTATION FAILED TO DELIVER GAS TO THE PATIENT. THE PATIENT SATURATION LEVEL (SP02) DECREASED TO APPROXIMATELY 80 BUT NO HARM TO THE PATIENT WAS REPORTED. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
157196 KION BSZ MAQUET CRITICAL CARE AB NA NA

Patients

Seq Age Sex Outcome Treatment
1 NI Required Intervention