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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Nihon Kohden Corporation ORG-9100A; Multiple Patient Receiver

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Nihon Kohden Corporation ORG-9100A; Multiple Patient Receiver Back to Search Results
Model Number ORG-9100A
Medical Device Problem Codes Failure to Read Input Signal (1581); Communication or Transmission Problem (2896)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/24/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The nurse reported that all their zm transmitters were in comm loss in ticket #252139.While troubleshooting the issue, technical support (ts) found that this org had a lit error light.They confirmed there were no network connection issues within the facility, and performing a 2-minute power-cycle did not resolve the issue.No patient harm was reported.Nihon kohden continues to investigate the reported event.Nihon kohden will submit a supplemental report in accordance with 21 cfr section 803.56 when additional information becomes available.
 
Event or Problem Description
The nurse reported that all their zm transmitters were in comm loss in ticket #252139.While troubleshooting the issue, technical support (ts) found that this org had a lit error light.No patient harm was reported.
 
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Brand Name
ORG-9100A
Common Device Name
Multiple Patient Receiver
Manufacturer (Section D)
Nihon Kohden Corporation
attn: shama mooman
1-31-4 nishiochia
shinjuku-ku, tokyo 161-8 560
JA  161-8560
Manufacturer (Section G)
Nihon Kohden Tomioka Corporation
attn: shama mooman
1-1 tajino
tomioka city, gunma 370-2 314
JA   370-2314
Manufacturer Contact
shama mooman
seibu bldg 2, 4th floor 1-11-2
kusunokidai tokorozawa, saitama 359-8-580
JA   359-8580
MDR Report Key25186714
Report Number8030229-2026-06615
Device Sequence Number10653287
Product Code DRG
UDI-Device Identifier04931921103883
UDI-Public(01)04931921103883
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K071058
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
Report Date (Section B) 08/14/2026
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 NumberORG-9100A
Device Catalogue NumberORG-9100A
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/31/2026
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/24/2026
Supplement Date Received by Manufacturer08/11/2026
Initial Report FDA Received Date05/15/2026
Supplement Report FDA Received Date08/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/30/2020
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 Reuse
Patient Sequence Number1
Patient SexUnknown
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