ROOT 25926 9515

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2020-01-24 for ROOT 25926 9515 manufactured by Masimo - 52 Discovery.

Event Text Entries

[179249663] Additional manufacturing narrative: other, other text: the returned device was evaluated. External visual inspection showed no damaged. The unit was unable to power on using either ac or battery power. Internal inspection isolated the failure to a component on the isolation board. Inspection of the component indicated it had shorted. Following the installation of a known-good isolation board the unit was fully functional. A service history record review reveals that this unit was in the field for over one (1) year with no previous reported issues related to this reported event.
Patient Sequence No: 1, Text Type: N, H10


[179249664] The customer reported the root wasn't able to be turned on after powering off during surgery. No patient impact or consequences were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3011353843-2020-00001
MDR Report Key9630133
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2020-01-24
Date of Report2019-12-30
Date of Event2019-12-27
Date Mfgr Received2019-12-30
Device Manufacturer Date2018-12-27
Date Added to Maude2020-01-24
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 ContactSTEFAN LISSMANN
Manufacturer Street52 DISCOVERY
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal92618
Manufacturer Phone9492977168
Manufacturer G1MASIMO - MEXICALI
Manufacturer StreetINDUSTRIAL VALLERA DE MEXICALI CALZADA DEL ORO, NO.2001
Manufacturer CityMEXICALI, BAJA CALIFORNIA 21600
Manufacturer CountryMX
Manufacturer Postal Code21600
Single Use3
Remedial ActionOT
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameROOT
Generic NameMONITOR, PHYSIOLOGICAL, PATIENT (WITHOUT ARRHYTHMIA DETECTION OR ALARMS)
Product CodeMWI
Date Received2020-01-24
Returned To Mfg2020-01-08
Model Number25926
Catalog Number9515
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMASIMO - 52 DISCOVERY
Manufacturer Address52 DISCOVERY IRVINE CA 92618 US 92618


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-24

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