|
It was reported the nurses did not hear an alarm generated for a desaturation event.The staff discovered the patient, an infant, that was blue in color and initiated resuscitation.It was noted there was no alarm prior to the patient being found but that an alarm was generated after resuscitation began.
|
|
A philips technical consultant (tc) was dispatched to the customer site.The event took place on (b)(6) 2025 at 10:51 in the nicu bed a601.The biomed instructed the end user to move the patient to a different monitor once the patient was stabilized.The tc was unable to reproduce the reported issue.Multiple test alarms were generated, and the audible alarm sounded correctly on the bedside monitor, surveillance central, and overview central; the speakers were operating properly.Following validation of the monitor, the tc released the device to customer use.The tc assisted the customer with obtaining the clinical audit trail from their in-house investigation into the issue.The customer declined further assistance from philips.The clinical audit logs were reviewed by the tc and a philips product support engineer (pse).The first desat was acknowledged at10:36:20 the bedside.This was just a few seconds after annunciation.The monitor reminded the users at 10:39, and again at 10:42 (3 min intervals) that the patient was still in the desat condition.The patient left desat at 10:42:46 and transitioned to spo2 low (yellow alarm) until 10:43:13 when they left that state with a normal spo2 value.Spo2 alarms were generated; however, the user had silenced/acknowledged the alarm.The reported problem was not confirmed.Information was provided to the customer.
|