BEUDAMED
    FDA Adverse Event Death Summary report: N

    NEWPORT HT50 VENTILATOR

    MDR report key: 587795 · Received April 5, 2005

    Report

    Report Number
    2023050-2005-00007
    Event Type
    Death
    Date Received
    April 5, 2005
    Date of Event
    November 11, 2004
    Report Date
    March 31, 2005
    Manufacturer
    NEWPORT MEDICAL INSTRUMENTS, INC.
    Product Code
    CBK
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    PT WAS NO THE VENTILATOR, THEN THE VENTILATOR ALARMED. PT WAS BAGGED. WHILE ON THE WAY TO THE HOSP, PT PASSED AWAY. (NO ADDITIONAL INFO IS AVAILABLE DUE TO THE REASON THAT THE DECEASED PT'S FAMILY WAS UNWILLING TO COOPERATE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NEWPORT HT50 VENTILATOR VENTILATOR CBK NEWPORT MEDICAL INSTRUMENTS, INC. HT50-H1 *

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Death