BEUDAMED
    FDA Adverse Event Death Summary report: N

    *

    MDR report key: 656572 · Received December 20, 2005

    Report

    Report Number
    MW4004106
    Event Type
    Death
    Date Received
    December 20, 2005
    Report Date
    November 16, 2005
    Manufacturer
    SALTER LABS
    Product Code
    CAT
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    RESPIRATORY THERAPIST

    Narratives

    Description of Event or Problem · 1

    KNOWN SMOKER: PT ALLEGEDLY LIT A CIGARETTE WHILE WEARING NASAL CANNULA AND USING OXYGEN FROM SIZE CYLINDER. REPORT FROM PT'S CAREGIVER INDICATED POSSIBILITY PATIENT WAS INTOXICATED AT THE TIME OF THE INCIDENT. EQUIPMENT AND CYLINDER RETURNED TO CO. NASAL CANNULA PRONGS SLIGHTLY BLACKENED - NO OTHER VISIBLE DAMAGE NOTED ON CYLINDER OR REGULATOR. CANNULA AND CYLINDER PHOTOGRAPHED. CYLINDER RETURNED EMPTY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * HASAL CANNULA CAT SALTER LABS 1600 *

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Death