OXYGEN HIGH PRESSURE HOSE 81-3311-06

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-03 for OXYGEN HIGH PRESSURE HOSE 81-3311-06 manufactured by Precision Medical, Inc..

Event Text Entries

[182328111] New oxygen high pressure hose was found to be not patent upon first use. Hose was attached to an air / o2 blender. Blender was placed in use in our nicu.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5093504
MDR Report Key9785945
Date Received2020-03-03
Date of Report2020-02-28
Date of Event2020-02-26
Date Added to Maude2020-03-04
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 Report3

Device Details

Brand NameOXYGEN HIGH PRESSURE HOSE
Generic NameTUBING, PRESSURE AND ACCESSORIES
Product CodeBYX
Date Received2020-03-03
Returned To Mfg2020-02-28
Model Number81-3311-06
Lot Number1913813-0
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerPRECISION MEDICAL, INC.
Manufacturer Address300 HELD DR NORTHAMPTON PA 18067 US 18067


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-03

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