| Brand Name | FLOW-I C20 |
| Common Device Name | GAS-MACHINE, ANESTHESIA |
| Manufacturer (Section D) |
| MAQUET CRITICAL CARE AB |
| roentgenvagen 2 |
| solna |
|
| Manufacturer (Section G) |
| MAQUET CRITICAL CARE AB |
| roentgenvagen 2 |
|
| solna |
|
| Manufacturer Contact |
|
caroline
kabbabe
|
| roentgenvagen 2 |
| solna
|
|
| MDR Report Key | 23566690 |
| Report Number | 8010042-2025-0001662 |
| Device Sequence Number | 21352555 |
| Product Code |
BSZ
|
| UDI-Device Identifier | 07325710001349 |
| UDI-Public | (01)07325710001349(11)200212 |
| Combination Product (Y/N) | N |
| Initial Reporter State | VA |
| Initial Reporter Country | US |
| PMA/510(K) Number | K191027 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility,Company Representative |
| Initial Reporter Occupation |
Biomedical Engineer
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
11/17/2025 |
| 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 | 6677200 |
| Device Catalogue Number | 6677200 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 10/29/2025 |
| Supplement Date Received by Manufacturer | 06/15/2026
|
| Initial Report FDA Received Date | 11/17/2025 |
| Supplement Report FDA Received Date | 06/16/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 02/12/2020 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Age | 49 YR |
| Patient Sex | Male |
| Patient Weight | 160 KG |
|
|