| Brand Name | XHIBIT CENTRAL STATION |
| Common Device Name | CENTRAL STATION REMOTE MONITOR |
| Manufacturer (Section D) |
| SPACELABS HEALTHCARE |
| 35301 se center st |
| snoqualmie WA 98065 |
|
| Manufacturer (Section G) |
| SPACELABS HEALTHCARE |
| 35301 se center st |
|
| snoqualmie WA 98065 |
|
| Manufacturer Contact |
|
whitney
snyder
|
| 35301 se center st |
| snoqualmie, WA 98065
|
|
| MDR Report Key | 23080595 |
| Report Number | 3010157426-2025-00175 |
| Device Sequence Number | 17385013 |
| Product Code |
MHX
|
| UDI-Device Identifier | 10841522100345 |
| UDI-Public | (01)10841522100345(11)190314 |
| Combination Product (Y/N) | N |
| Initial Reporter State | WA |
| Initial Reporter Country | US |
| PMA/510(K) Number | K122146 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Unknown |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility |
| Initial Reporter Occupation |
Biomedical Engineer
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/17/2025 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | 96102 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Date Returned to Manufacturer | 08/19/2025 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/18/2025 |
| Initial Report FDA Received Date | 09/17/2025 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 03/14/2019 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |