BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DRAGER

    MDR report key: 770336 · Received October 16, 2006

    Report

    Report Number
    MW1040697
    Event Type
    Injury
    Date Received
    October 16, 2006
    Date of Event
    July 27, 2006
    Report Date
    October 16, 2006
    Manufacturer
    DRE INC
    Product Code
    CBK
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DRAGER VENT. SCREEN WENT BLANK AND THE VENTILATOR STARTED TO MAKE A LOUD HIGH PITCHED NOISE. THE STAFF TURNED THE VENT. OFF. PT BAGGED AND RESPIRATORY STATUS WAS MAINTAINED WITH O2 SATS AT 100%. THE PT SUFFERED NO ILL EFFECTS FROM THIS INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DRAGER VENTILATOR CBK DRE INC EVITA XL 16 *

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Disability