FDA Adverse Event Malfunction Summary report: N

RADICAL DOCKING STATION, RDS-1

MDR report key: 4213218 · Received October 1, 2014

Report

Report Number
2031172-2014-00219
Event Type
Malfunction
Date Received
October 1, 2014
Date of Event
September 1, 2014
Report Date
September 1, 2014
Manufacturer
MASIMO CORPORATION
Product Code
DQA
PMA / PMN Number
K080238
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RETURNED TO MASIMO FOR EVAL. WHEN THE INVESTIGATION IS COMPLETE A F/U REPORT WILL BE SUBMITTED. NO PT INVOLVEMENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PROBE OFF SYMPTOM OCCURRED DURING THE SET-UP BEFORE CLINICAL USE. THE SENSOR WAS NOT APPLIED TO FINGER, BUT SPO2 INDICATED 100%. THE UNIT WAS CONNECTED TO A NIHON KOHDEN MONITOR. HEALTHCARE WORKERS TRIED TO EXCHANGE TO ANOTHER HANDHELD, DRC-1 AND RED LNC-10. ALSO, THEY TRIED TO REBOOT THE HANDHELD, BUT THE SYMPTOM WAS NOT RESOLVED. NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
612024 RADICAL DOCKING STATION, RDS-1 OXIMETER DQA MASIMO CORPORATION 1310

Patients

Seq Age Sex Outcome Treatment
1