BIS 186-0224-AMS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2018-12-05 for BIS 186-0224-AMS manufactured by Jabil Circuit Singapore Pte Ltd.

Event Text Entries

[129480796] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[129480797] According to the reporter, the readings provided by the unit was not what they are expecting. The customer reported that the unit gave a low value. There was no patient injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2936999-2018-00764
MDR Report Key8136252
Report SourceUSER FACILITY
Date Received2018-12-05
Date of Report2018-12-05
Date Mfgr Received2018-11-13
Date Added to Maude2018-12-05
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactAVI KLUGER
Manufacturer Street5920 LONGBOW DRIVE
Manufacturer CityBOULDER CO 80301
Manufacturer CountryUS
Manufacturer Postal80301
Manufacturer Phone3035306582
Manufacturer G1JABIL CIRCUIT SINGAPORE PTE LTD
Manufacturer Street16 TAMPINES CRESCENT
Manufacturer CitySINGAPORE 528604
Manufacturer CountrySG
Manufacturer Postal Code528604
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBIS
Product CodeOLW
Date Received2018-12-05
Model Number186-0224-AMS
Catalog Number186-0224-AMS
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerJABIL CIRCUIT SINGAPORE PTE LTD
Manufacturer Address16 TAMPINES CRESCENT SINGAPORE 528604 SG 528604


Patients

Patient NumberTreatmentOutcomeDate
10 2018-12-05

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