GAS MODULE III

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2013-10-11 for GAS MODULE III manufactured by Mindray Ds Usa, Inc.

Event Text Entries

[3935814] Customer reported an issue with the gas module iii, which may affected gas monitoring. No patient injury was reported.
Patient Sequence No: 1, Text Type: D, B5


[11212117] Company rep evaluated the unit. Corrections included replacement of a broken 02 connector and small diameter tubing and adjusted power supply. The unit was tested, calibrated and safety checked to factory specifications.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2221819-2013-02086
MDR Report Key3458041
Report Source05,06,07
Date Received2013-10-11
Date of Report2013-09-16
Date of Event2013-09-14
Date Mfgr Received2013-09-16
Date Added to Maude2014-01-15
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactWISARA SETHACHUTKUL
Manufacturer Street800 MACARTHUR BLVD.
Manufacturer CityMAHWAH NJ 07430
Manufacturer CountryUS
Manufacturer Postal07430
Manufacturer Phone2019558045
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGAS MODULE III
Generic NameGAS MONITOR
Product CodeBZK
Date Received2013-10-11
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMINDRAY DS USA, INC
Manufacturer AddressMAHWAH NJ US


Patients

Patient NumberTreatmentOutcomeDate
10 2013-10-11

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