BEUDAMED
    FDA Adverse Event Death Summary report: N

    EVITA

    MDR report key: 412616 · Received August 22, 2002

    Report

    Report Number
    2517967-2002-00064
    Event Type
    Death
    Date Received
    August 22, 2002
    Date of Event
    July 23, 2002
    Report Date
    August 22, 2002
    Manufacturer
    DRAEGER MEDICAL, INC.
    Product Code
    CBK
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT: THE FACILITY EXPERIENCED AN ELECTRICAL STORM, WHICH CAUSED A MOMENTARY LOSS OF ELECTRICAL POWER AT THE FACILITY. THE CIRCUIT BREAKERS ON THE AIR COMPRESSORS AT THE FACILITY OPENED, WHICH LED TO THE LOSS OF AIR PIPELINE SUPPLY. A PT WAS BEING VENTILATED AT THE TIME OF THE POWER LOSS. THE PT WAS IN ICU AND WAS BEING MONITORED BY A HEART MONITOR, WENT ASYSTOLE, AND WAS THEN BAGGED BY HOSP PERSONNEL. AN HOUR AFTER THE POWER LOSS THE PT DIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EVITA CONTINUOUS VENTILATOR CBK DRAEGER MEDICAL, INC. 2 DURA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Death