HILL-ROM/ AIRSHIELDS-DRAGER C2HS-1 SERIES 03

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-07 for HILL-ROM/ AIRSHIELDS-DRAGER C2HS-1 SERIES 03 manufactured by Draeger Medical System, Inc..

Event Text Entries

[110716663] Infant in isolette for phototherapy. Had been active in the bed needing re-positioning. Apparently fell through porthole of isolette to floor. Unwitnessed by rn. This porthole had not been opened during patient cares at all.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5077691
MDR Report Key7582139
Date Received2018-06-07
Date of Report2018-06-05
Date of Event2018-05-24
Date Added to Maude2018-06-08
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
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
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHILL-ROM/ AIRSHIELDS-DRAGER
Generic NameISOLETTE
Product CodeFMZ
Date Received2018-06-07
Model NumberC2HS-1
Catalog NumberSERIES 03
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerDRAEGER MEDICAL SYSTEM, INC.
Manufacturer AddressTELEFORD PA 18969 US 18969


Patients

Patient NumberTreatmentOutcomeDate
10 2018-06-07

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