BEUDAMED
    FDA Adverse Event Death Summary report: N

    PRECISION MEDICAL FLOW SELECTOR

    MDR report key: 567743 · Received January 21, 2005

    Report

    Report Number
    567743
    Event Type
    Death
    Date Received
    January 21, 2005
    Date of Event
    November 27, 2004
    Report Date
    January 21, 2005
    Manufacturer
    PRECISION MEDICAL
    Product Code
    BXY
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    AFTER TRANSPORT OF PT, RN CONNECTED O2 TUBING TO THE FLOW SELECTOR CONNECTOR PORT MOST PROMINENT AND CLOSEST TO HER. APPROX. 45 MINS. LATER, O2 TUBING FOUND TO BE CONNECTED TO CLOSED PORT OF FLOW SELECTOR, NOT PORT OPENED TO O2 FLOW.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRECISION MEDICAL FLOW SELECTOR FLOW SELECTOR BXY PRECISION MEDICAL UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Death