BEUDAMED
    FDA Adverse Event Other Summary report: N

    UNK

    MDR report key: 572935 · Received February 10, 2005

    Report

    Report Number
    572935
    Event Type
    Other
    Date Received
    February 10, 2005
    Date of Event
    November 1, 2004
    Report Date
    February 10, 2005
    Manufacturer
    UNK
    Product Code
    CAN
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS ON OXYGEN PER NASAL CANNULA. THE PATIENT HAD OXYGEN AND AIR REGULATORS CONNECTED TO THE HEAD WALL CORRECTLY. THE RN NOTICED THAT THE PATIENT'S OXYGEN SATURATION WAS DROPPING AND DISCOVERED THAT THE NASAL CANNULA WAS INCORRECTLY CONNECTED TO THE AIR OUTLET. BOTH THE AIR AND OXYGEN OUTLETS HAD GREEN CHRISTMAS TREE ADAPTERS. THE PATIENT RECOVERED WITHOUT INJURY OR INSULT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK OXYGEN AND AIR OUTLET WITH FLOWMETERS CAN UNK UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR