BEUDAMED
    FDA Adverse Event Other Summary report: N

    SC7000

    MDR report key: 511044 · Received January 14, 2004

    Report

    Report Number
    1220063-2004-00001
    Event Type
    Other
    Date Received
    January 14, 2004
    Date of Event
    December 12, 2003
    Report Date
    January 13, 2004
    Manufacturer
    DRAEGER MEDICAL SYSTEMS, INC.
    Product Code
    DSI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED: IN THE EMERGENCY ROOM, A NURSE WAS ATTEMPTING TO DOCK THE PT MONITOR ONTO THE DOCKING STATION AND IT WAS NOTED THAT THE MONITOR FELL OFF OF THE DOCKING STATION AND HIT THE FLOOR. THERE WAS NO INJURY INVOLVED. A BIOMED AT THE FACILITY PERFORMED AN EVALUATION OF THE DOCKING STATION AND REPORTED THAT THE CONNECTION DOOR COVER / LOCKING MECHANISM ON THE DOCKING STATION WAS LOOSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SC7000 MODULAR PT MONITOR DSI DRAEGER MEDICAL SYSTEMS, INC. 5202994E539U NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other DRAEGER MEDICAL SYSTEMS - INFINITY DOCKING STATION| (PN 5594887EE56U).