MAUDE Adverse Event Report: MASIMO - 15750 ALTON PKWY RAD-5 HANDHELD PULSE OX; OXIMETER

Model Number	9196
Medical Device Problem Code	Incorrect Measurement (1383)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	10/05/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Other, other text: the device was received by masimo japan; however, the customer requested the return of the product and refused repairs and failure analysis of the device.Therefore, an evaluation of the device was unable to be performed.If new information is obtained, or the device is sent back to masimo for analysis a follow up report will be submitted.E1.Initial reporter zip code exceeded the maximum allowable characters; zip code is as follows: (b)(6).Health effect impact code: no adverse event; no patient impact h3 other text: product not returned.
Event or Problem Description
The customer reported that the device provides "inaccurate [spo2] readings".There was no patient impact or consequence reported.

• Brand Name: RAD-5 HANDHELD PULSE OX
• 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 Key: 23376129
• Report Number: 3019388613-2025-00129
• Device Sequence Number: 15726051
• Product Code: DQA
• UDI-Device Identifier: 00843997005517
• UDI-Public: (01)00843997005517(11)150429
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K033998
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,User Facility
• Initial Reporter Occupation: Other Health Care Professional
• Remedial Action: Other
• Type of Report: Initial
• Report Date (Section B): 10/06/2025

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: 9196
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 10/06/2025
• Initial Report FDA Received Date: 10/23/2025
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 04/29/2015
• 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 Number: 1
• Patient Sex: Unknown