FDA Adverse Event Injury Summary report: N

NASAL ALAR SPO2 SENSOR

MDR report key: 8769198 · Received July 8, 2019

Report

Report Number
3010150334-2019-00003
Event Type
Injury
Date Received
July 8, 2019
Date of Event
November 8, 2017
Report Date
July 8, 2019
Manufacturer
XHALE ASSURANCE, INC
Product Code
DQA
PMA / PMN Number
K171423
Removal / Correction Number
3010150334-50819-001-C
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PATIENT WAS INTUBATED ON THE (B)(6) - 3 DAYS LATER THE SENSOR WAS REMOVED FROM THE RIGHT NARES AND THE LESION WAS NOTED - BETWEEN NURSING AND RT THEY ESTIMATE THE SENSOR HAD BEEN IN PLACE 26-28 HOURS. WOUND CARE WAS CONSULTED AND NOTED THE LESION TO BE .5X.7 PURPLE/BLACK WITH NO DRAINAGE. THE PATIENT HAS SINCE EXPIRED SO THERE IS NO FOLLOW UP ON THE WOUND. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. THIS REPORT WILL BE UPDATED IF RELEVANT INFORMATION BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
563419 NASAL ALAR SPO2 SENSOR OXIMETER, PROBE, SINGLE USE DQA XHALE ASSURANCE, INC 301-11214

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention