BEUDAMED
    FDA Adverse Event Other Summary report: N

    IMPACT INSTRUMENTATION INC

    MDR report key: 748471 · Received August 8, 2006

    Report

    Report Number
    748471
    Event Type
    Other
    Date Received
    August 8, 2006
    Date of Event
    July 30, 2006
    Report Date
    August 2, 2006
    Manufacturer
    IMPACT INSTRUMENTATION INC
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA
    Reporter Occupation
    PARAMEDIC

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS BEING TRANSFERED FROM HOSPITAL TO HOSPITAL WHEN VENT ALARMED "VENT FAILURE" #5 EXALATION VALVE. PT WAS TAKEN OFF THE VENT AND BAGGED THE REMAINING TRIP WITH NO COMPROMISE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IMPACT INSTRUMENTATION INC MODEL 754 EAGLE VENT CBK IMPACT INSTRUMENTATION INC EAGLE VENT 754 *

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Other