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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MASIMO - 15750 ALTON PKWY RAD-G; OXIMETER

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MASIMO - 15750 ALTON PKWY RAD-G; OXIMETER Back to Search Results
Model Number 9847
Medical Device Problem Code Unexpected Shutdown (4019)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/22/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Other, other text: masimo has reached out to request the return of the device.The device has not been returned to masimo to allow an analysis to be performed.If the device is returned for evaluation or new information is obtained, a follow up report will be submitted.Health effect impact code: no adverse event, no patient impact.Masimo initiated a recall for this issue and notified us fda on 02/15/2024.The recall number is z-1537-2024.H3 other text: device not returned.
 
Event or Problem Description
The customer reported the rad-g "powered [off] by itself." no patient impact or consequences were reported.
 
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Brand Name
RAD-G
Common Device Name
OXIMETER
Manufacturer (Section D)
MASIMO - 15750 ALTON PKWY
15750 alton pkwy
irvine CA 92618
Manufacturer (Section G)
MASIMO - MEXICALI
industrial vallera de mexicali calzada del oro, no.2001
mexicali, baja california 21600
MX   21600
Manufacturer Contact
tahereh sedighi
15750 alton pkwy
irvine, CA 92618
9492977862
MDR Report Key23353914
Report Number3019388613-2025-00127
Device Sequence Number9018770
Product Code DQA
UDI-Device Identifier00843997013284
UDI-Public(01)00843997013284(11)220718
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K213676
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Consumer
Initial Reporter Occupation Non-Healthcare Professional
Remedial Action Recall
Type of Report Initial
Report Date (Section B) 09/22/2025
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 Number9847
Device Catalogue Number9847
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/22/2025
Initial Report FDA Received Date10/21/2025
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured07/22/2018
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 Unknown
Patient Sequence Number1
Patient SexUnknown
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