CAREFUSION

Report

• Report Number: MW5064783
• Event Type: Death
• Date Received: September 15, 2016
• Date of Event: April 8, 2016
• Report Date: September 1, 2016
• Manufacturer: CAREFUSION
• Product Code: CBK
• Adverse Event: Yes
• Report Source: Voluntary report
• Reporter Location: IL, US
• Reporter Occupation: OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

PT AWOKE FROM NAP ON LTV 1150 VENTILATOR, HAD CARDIORESPIRATORY ARREST (REASON UNK, WITNESSED BY NURSE, CPR INITIATED, 911 CALLED). EMS TRANSPORTED PT TO EMERGENCY DEPARTMENT. PT EXPIRED A FEW HOURS LATER. EQUIPMENT WAS PICKED UP, TESTED BY INDEPENDENT BIO MEDICAL TECHNICIANS. EQUIPMENT WAS THEN FORWARDED TO MANUFACTURER FOR ADD'L TESTING AND DOWNLOAD OF DATA. ALL TESTING CAME BACK NEGATIVE FOR FAILURE OR ERRORS. POST MORTEM RESULTS REQUESTED BUT NOT OBTAINED.

Devices

Seq	Brand	Generic	Product Code	Manufacturer	Model	Lot	UDI-DI
603482	CAREFUSION	LTV VENTILATOR	CBK	CAREFUSION	1150

Patients

Seq	Age	Sex	Outcome	Treatment
1	1 YR		Death

Terms

Patient problem · 1

• Death

Product problems · 1

• Adverse Event Without Identified Device or Use Problem

Type of report · 1

• Initial submission