SSCOR SUCTION DEVICES 2100S

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2018-07-24 for SSCOR SUCTION DEVICES 2100S manufactured by Sscor, Inc..

Event Text Entries

[114938459] Device reported was manufactured on 11/10/2009, device still had the original battery which is over 9 years old. Sscor's manual/labeling recommends that device batteries be replaced every 3 years and to keep the device on charge at all times. The only way to assure the battery has a functional capacity, is to perform the battery check suggested on the sscor manual. Sscor sent user a replacement battery as good faith. The user replaced the battery on the device and it worked to specification. No patient details were provided to sscor.
Patient Sequence No: 1, Text Type: N, H10


[114938460] Per customer (user): "b shift passed along some information this morning in regards to the suction units on m61. Apparently they had a cpr call and both suction units (red bag and wall mount) died. They said the red bag unit worked for about 2 minutes, and the wall mount worked for only a couple seconds. Call was for a patient in cardiac arrest, issue with device did not contribute to the patients outcome. Several suction units were on scene and available during the emergency. "
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2022724-2018-00002
MDR Report Key7716860
Report SourceHEALTH PROFESSIONAL
Date Received2018-07-24
Date of Report2018-07-23
Date Mfgr Received2018-06-24
Device Manufacturer Date2009-11-10
Date Added to Maude2018-07-24
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 ContactMS. MAIRA OJEDA
Manufacturer Street11064 RANDALL ST.
Manufacturer CitySUN VALLEY CA 91352
Manufacturer CountryUS
Manufacturer Postal91352
Manufacturer Phone8185044054
Manufacturer G1SSCOR, INC.
Manufacturer Street11064 RANDALL ST.
Manufacturer CitySUN VALLEY CA 91352
Manufacturer CountryUS
Manufacturer Postal Code91352
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSSCOR SUCTION DEVICES
Generic NameS-SCORT? TEN PORTABLE SUCTION
Product CodeBTA
Date Received2018-07-24
Model Number2100S
Catalog Number2100S
Lot NumberN/A
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSSCOR, INC.
Manufacturer Address11064 RANDALL ST. SUN VALLEY CA 91352 US 91352


Patients

Patient NumberTreatmentOutcomeDate
101. Death 2018-07-24

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