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 2014-10-22 for GAS MODULE III manufactured by Mindray Ds Usa, Inc.
[5042368]
Customer reported an intermittent issue with the gas module iii, which may have affected gas monitoring. No pt injury was reported.
Patient Sequence No: 1, Text Type: D, B5
[12399548]
Company rep evaluated the system and could not duplicate the problem. Unit has been sent to the company's repair center for further eval.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 2221819-2014-00804 |
| MDR Report Key | 4217052 |
| Report Source | 05,06,07 |
| Date Received | 2014-10-22 |
| Date of Report | 2014-09-22 |
| Date of Event | 2014-09-17 |
| Date Mfgr Received | 2014-09-22 |
| Date Added to Maude | 2014-11-04 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | WISARA SETHACHUTKUL |
| Manufacturer Street | 800 MACARTHUR BLVD. |
| Manufacturer City | MAHWAH NJ 07430 |
| Manufacturer Country | US |
| Manufacturer Postal | 07430 |
| Manufacturer Phone | 2019958045 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | GAS MODULE III |
| Generic Name | GAS MODULE |
| Product Code | BZK |
| Date Received | 2014-10-22 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MINDRAY DS USA, INC |
| Manufacturer Address | MAHWAH NJ US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2014-10-22 |