FDA Adverse Event Death Summary report: N

OXIMAX N600X PULSE OXIMETER

MDR report key: 4042201 · Received July 21, 2014

Report

Report Number
2936999-2014-00653
Event Type
Death
Date Received
July 21, 2014
Date of Event
June 14, 2014
Report Date
June 25, 2014
Manufacturer
COVIDIEN
Product Code
DQA
PMA / PMN Number
K123581
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

COVIDIEN CURRENTLY HAS THE DEVICE, AND THE INVESTIGATION IS IN PROGRESS. (B)(4).

Description of Event or Problem · 1

COVIDIEN RECEIVED INFORMATION REPORTING THE DEATH OF A PATIENT WHO WAS BEING MONITORED BY AN N-600X PULSE OXIMETER. THE MOTHER OF THE PATIENT REPORTED THE DEATH TO THE HOME-CARE EQUIPMENT PROVIDER (PEDIATRIC HOME SERVICE). THE MOTHER OF THE PATIENT REPORTED THAT SHE DID NOT KNOW WHETHER THE AUDIBLE ALARM DID NOT SOUND OR WHETHER THE ALARM SOUNDED BUT SHE DID NOT HEAR IT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
426867 OXIMAX N600X PULSE OXIMETER PULSE OXIMETER DQA COVIDIEN

Patients

Seq Age Sex Outcome Treatment
1 5 YR Death