BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CHEMETRON ADAPTER DISS MALE OXY USA

    MDR report key: 5129973 · Received September 30, 2015

    Report

    Report Number
    MW5056840
    Event Type
    Malfunction
    Date Received
    September 30, 2015
    Date of Event
    September 22, 2015
    Report Date
    September 30, 2015
    Manufacturer
    CHEMETRON AMVEX CORPORATION
    Product Code
    CBO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE CONNECTOR SEPARATE FROM MAIN BODY SLOWLY WITH USE. WHEN YOU CONNECT TO THE WALL OXYGEN, IT DOES NOT CATCH. THIS PREVENTS THE PT FROM GETTING FULL OXYGEN. THIS PROBLEM OCCURRED OVERTIME. IT IS A PROBLEM WITH THE DEVICE AS IT WEARS BUT THERE WASN'T A SIGNIFICANT EVENT THAT AFFECTED A PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    644426 CHEMETRON ADAPTER DISS MALE OXY USA CHEMETRON ADAPTER DISS MALE OXY USA CBO CHEMETRON AMVEX CORPORATION

    Patients

    Seq Age Sex Outcome Treatment
    1