BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AIR SHIELDS

    MDR report key: 510956 · Received January 27, 2004

    Report

    Report Number
    MW1030980
    Event Type
    Malfunction
    Date Received
    January 27, 2004
    Date of Event
    December 10, 2003
    Report Date
    January 27, 2004
    Manufacturer
    HILL-ROM / AIR SHIELDS
    Product Code
    GCX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    LA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN REQUESTED SUCTION - SUCTION UNIT WOULD NOT FUNCTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AIR SHIELDS SUCTION MACHINE GCX HILL-ROM / AIR SHIELDS EF *

    Patients

    Seq Age Sex Outcome Treatment
    1 3 YR