FDA Adverse Event Death Summary report: N

VISTA XL

MDR report key: 3853647 · Received May 29, 2014

Report

Report Number
1220063-2014-00020
Event Type
Death
Date Received
May 29, 2014
Date of Event
April 27, 2014
Report Date
May 4, 2014
Manufacturer
DRAEGER MEDICAL SYSTEMS, INC.
Product Code
MHX
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DRAEGER IS STILL INVESTIGATION THE REPORTED INCIDENT. A F/U REPORT WILL BE SUBMITTED AS SOON AS THE INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DOCTOR (B)(6) FROM (B)(6) HOSPITAL-MEDINAH NICU DEPARTMENT, WHO OBSERVED THIS CASE, SAID THAT HE HAD PATIENT CONNECTED WITH INFINITY VISTA XL MONITOR (SPO2 SENSOR ONLY). THE PATIENT WAS DEAD, BUT THE O2 SATURATION STILL APPEARED ON THE MONITOR. DRAEGER REFERENCE NUMBER: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
317339 VISTA XL PATIENT MONITOR MHX DRAEGER MEDICAL SYSTEMS, INC. MS18986 NA

Patients

Seq Age Sex Outcome Treatment
1 Death NO