BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GOODKNIGHT 4200

    MDR report key: 607630 · Received May 20, 2005

    Report

    Report Number
    9615679-2005-00001
    Event Type
    Malfunction
    Date Received
    May 20, 2005
    Date of Event
    January 7, 2005
    Report Date
    January 28, 2005
    Manufacturer
    MALLINCKRODT DEVELOPPEMENT FRANCE
    Product Code
    BYE
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THE PT SAID AC/DC POWER SUPPLY BURNT AND FLAMES HAD BEEN PROJECTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GOODKNIGHT 4200 NASAL CPAP SYSTEM BYE MALLINCKRODT DEVELOPPEMENT FRANCE M-113900-US *

    Patients

    Seq Age Sex Outcome Treatment
    1 *