BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDICAL GAS FLOW METER

    MDR report key: 510440 · Received December 1, 2003

    Report

    Report Number
    510440
    Event Type
    Malfunction
    Date Received
    December 1, 2003
    Date of Event
    December 1, 2003
    Report Date
    December 1, 2003
    Manufacturer
    FLOTEC, INC.
    Product Code
    CCN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDICAL GAS FLOW METER GAS FLOW METER CCN FLOTEC, INC. F56-210D2 *

    Patients

    Seq Age Sex Outcome Treatment
    1 5 MO Other