MAUDE MDR 3963284

MDR report key
3963284
Report number
2936999-2014-00525
Event key
0
Event type
3
Date of event
2014-05-01
Date received
2014-06-18
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
DENISE BRAXTON
Address
6135 GUNBARREL AVE. BOULDER CO 80301 US
Phone
303-303-3038
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1OXIMETER N-560 PULSE OXIMETERPULSE OXIMETERMEDIANADPZN-560N560Y Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12014-06-180

Event Narratives#

D

Patient 1

IT WAS REPORTED TO COVIDIEN THAT THE UNIT HAD A BLANK DISPLAY. COVIDIEN TECHNICIAN FOUND THAT THE UNIT HAD SEGMENTS MISSING IN THE DISPLAY. THERE WAS NO PT INVOLVEMENT.

N

Patient 1

COVIDIEN SERVICE CTR REPLACED THE FRONT PCB AND MAIN BOARD. (B)(4). THE SERIAL NUMBER OF THE DISPLAY PCB PRECEDES A CORRECTIVE AND PREVENTIVE ACTION TAKEN BY THE MANUFACTURER.