Brand Name | SYSTEM ONE REMSTAR AUTO A-FLEX |
Type of Device | VENTILATOR, CONTINUOUS, NON-LIFE-SUPPORTING |
Manufacturer (Section D) |
|
MDR Report Key | 15894412 |
MDR Text Key | 304740462 |
Report Number | MW5113561 |
Device Sequence Number | 3 |
Product Code |
MNS
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
11/28/2022 |
5 Devices were Involved in the Event: |
1
2
3
4
5
|
1 Patient was Involved in the Event |
|
Date FDA Received | 11/30/2022 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Lay User/Patient
|
Was Device Available for Evaluation? |
Yes
|
Patient Sequence Number | 1 |
Treatment | COZAAR/HYZAAR, SYNTHROID, RABEPRAZOLE. CANE OR WALKER AS NEEDED.; VITAMIN D3, EXTRA STRENGTH TYLENOL AND/OR ALEVE AS NEEDED FOR PAIN. |
Patient Outcome(s) |
Other;
|
Patient Age | 65 YR |
Patient Sex | Female |
Patient Weight | 123 KG |
Patient Ethnicity | Non Hispanic |
Patient Race | White |
|
|