BEUDAMED
    FDA Adverse Event Death Summary report: N

    THUMPER

    MDR report key: 555557 · Received November 15, 2004

    Report

    Report Number
    1821850-2004-00014
    Event Type
    Death
    Date Received
    November 15, 2004
    Date of Event
    November 4, 2004
    Report Date
    November 8, 2004
    Manufacturer
    MICHIGAN INSTRUMENTS, INC.
    Product Code
    DRM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TW
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    UPON APPLICATION TO THE PT, THE DEVICE WAS FOUND NOT TO BE FUNCTIONING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 THUMPER CARDIOPULMONARY RESUSCITATOR DRM MICHIGAN INSTRUMENTS, INC. 1007 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Death