RESUS,ADLT W/MSK,LRG TBG, P/O, 6/CS 2K8032

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-04-29 for RESUS,ADLT W/MSK,LRG TBG, P/O, 6/CS 2K8032 manufactured by Carefusion/bd.

Event Text Entries

[74012101] Customer advocacy has reached out to customer to provide sample for the investigation. Ups label was provided to the customer. At this time we are currently waiting for the sample. Once the investigation is complete or if we receive any additional information we will provide a follow up emdr. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[74012102] Customer reported that the "bag does not inflate". Reported item was being used on patient. No patient harm or medical intervention was required. Customer report "that the patient did not have a low oxygen saturation the device was replaced immediately upon noticing the issue".
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8030673-2017-00329
MDR Report Key6533004
Date Received2017-04-29
Date of Report2017-08-04
Date of Event2017-03-20
Date Mfgr Received2017-07-17
Date Added to Maude2017-04-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMINDY FABER
Manufacturer Street75 NORTH FAIRWAY DRIVE
Manufacturer CityVERNON HILLS IL 60061
Manufacturer CountryUS
Manufacturer Postal60061
Manufacturer G1CAREFUSION/BD
Manufacturer StreetCERRADA V NO.85 PARQUE INDUSTRIAL
Manufacturer CityMEXICALI BAJA CALIFORNIA NORTE
Manufacturer CountryMX
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameRESUS,ADLT W/MSK,LRG TBG, P/O, 6/CS
Generic NameCARDIOPULMONARY RESUSCITATION AID KIT
Product CodeOEV
Date Received2017-04-29
Returned To Mfg2017-06-08
Catalog Number2K8032
Lot Number0000710419
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCAREFUSION/BD
Manufacturer AddressCERRADA V?A DE LA PRODUCCI?N NO. 85 PARQUE INDUSTRIAL MEXICALI BAJA CALIFORNIA NORTE MX


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-04-29

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