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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: FLOW METER, OXYGEN Y CONNECTOR
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FLOW METER, OXYGEN Y CONNECTOR Back to Search Results
Device Problem Detachment Of Device Component (1104)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 06/11/2014
Event Type  Injury  
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Brand Name
FLOW METER, OXYGEN Y CONNECTOR
Type of Device
FLOW METER, OXYGEN Y CONNECTOR
MDR Report Key4246523
Report Number4246523
Device Sequence Number1
Product Code BZH
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source User Facility
Type of Report Initial
Report Date 07/16/2014
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/16/2014
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Invalid Data
Was Device Available for Evaluation? Yes
Was the Report Sent to FDA? Yes
Date Report Sent to FDA07/16/2014
Event Location Hospital
Date Report to Manufacturer11/04/2014
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age59 YR
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