BEUDAMED
    FDA Adverse Event Death Summary report: N

    CODEMASTER 100

    MDR report key: 513141 · Received February 27, 2004

    Report

    Report Number
    1218950-2004-00043
    Event Type
    Death
    Date Received
    February 27, 2004
    Date of Event
    January 28, 2004
    Report Date
    January 28, 2004
    Manufacturer
    AGILENT TECHNOLOGIES, INC.
    Product Code
    LDD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    PARAMEDIC

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT DURING A CODE, A SPARK OR ARC FROM THE DEFIBRILLATOR OR ACCESSORIES SET THE PATIENT'S CLOTHING AND HAIR ON FIRE WHILE BEING TRANSPORTED IN AN AMBULANCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CODEMASTER 100 PORTABLE DEFIB/MONITOR LDD AGILENT TECHNOLOGIES, INC. M2475B NA

    Patients

    Seq Age Sex Outcome Treatment
    1 47 YR Death