FDA Adverse Event Injury Summary report: N

NASAL ALAR SPO2 SENSOR

MDR report key: 8771513 · Received July 9, 2019

Report

Report Number
3010150334-2019-00005
Event Type
Injury
Date Received
July 9, 2019
Date of Event
November 17, 2017
Report Date
July 9, 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
OH, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

FACILITY HAD TWO PATIENTS THAT HAVE HAD SUSPECTED PRESSURE ISSUES RELATED TO THE SENSOR. COULD NOT CONFIRM THAT SITES WERE BEING ROTATED EVERY 12 HOURS AS RECOMMENDED. THERE IS NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. THIS REPORT WILL BE UPDATED IF RELEVANT BECOMES AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
565541 NASAL ALAR SPO2 SENSOR OXIMETER, PROBE, SINGLE USE DQA XHALE ASSURANCE, INC 301-11214

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention