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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MASIMO - 15750 ALTON PKWY LNCS INF ADHESIVE SENSOR; OXIMETER

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MASIMO - 15750 ALTON PKWY LNCS INF ADHESIVE SENSOR; OXIMETER Back to Search Results
Model Number 2328
Medical Device Problem Code Low Readings (2460)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/23/2026
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported a severe desaturation occurred, dropping to 70%, with a good plethysmography waveform and no improvement despite increasing the fio2.No recurrence was observed, and the patient's postoperative recovery was uneventful.
 
Additional Manufacturer Narrative
Other text: masimo has reached out to the customer 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.E1.Initial reporter phone number exceeded maximum allowable digits, phone number is as follows: (b)(6).Health effect impact code: no adverse event; no patient impact.
 
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Brand Name
LNCS INF ADHESIVE SENSOR
Common Device Name
OXIMETER
Manufacturer (Section D)
MASIMO - 15750 ALTON PKWY
15750 alton pkwy
irvine CA 92618
Manufacturer (Section G)
MASIMO - MEDICAL TECHNOLOGIES (MALAYSIA) SDN BHD
lot 198512, (plo 547-b) jalan keluli 11, zon 12a
kawasan perindustrian pasir gudang 81700
MY   81700
Manufacturer Contact
lusine boyadzhyan
15750 alton pkwy
irvine, CA 92618
9492977167
MDR Report Key24811957
Report Number3019388613-2026-00133
Device Sequence Number6027089
Product Code DQA
UDI-Device Identifier10843997000915
UDI-Public(01)10843997000915(17)280101(10)25AP8
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K101896
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility
Initial Reporter Occupation Biomedical Engineer
Remedial Action Other
Type of Report Initial,Followup
Report Date (Section B) 03/19/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number2328
Device Lot Number25AP8
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 03/19/2026
Supplement Date Received by Manufacturer05/07/2026
Initial Report FDA Received Date04/07/2026
Supplement Report FDA Received Date05/28/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/08/2025
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
Outcome Attributed to Adverse Event Other;
Patient Age4 YR
Patient SexUnknown
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