inforMED
DeathOLT

EEG

Received Mar 28, 2019 · Event occurred Feb 28, 2019

Report 8030229-2019-00077 · MDR key 8460248

Device

Generic name

Neurofax Electroencephalograph

Model number

EEG-1200A

Catalog number

EEG-1200A

Lot number

NOT APPLICABLE

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

Not reported

  • Death
  • Patient Problem/Medical Problem
  • Death
  • Patient Problem/Medical Problem

Narrative

Additional Manufacturer Narrative

CORRECTED DATA: F7: TYPE OF REPORT. G7: TYPE OF REPORT. H2: IF FOLLOW-UP, WHAT TYPE (CORRECTION OR ADDITIONAL OR BOTH). H6: EVEN PROBLEM AND EVALUATION CODES. ADDITIONAL INFORMATION: H10: MANUFACTURE NARRATIVE: DETAILS OF COMPLAINT: STUDIES DID NOT COPY TO SHARE. SERVICE REQUESTED: TROUBLESHOOTING. SERVICE PERFORMED: TROUBLESHOOTING. INVESTIGATION RESULT: THEIR PATIENT PASSED AWAY, THEN THE RN PULLED THE EQUIPMENT PLUG FROM THE WALL CAUSING THE COPY TO FAIL. THIS IS CONSIDERED AND UNGRACEFUL EXIT FOR THE EQUIPMENT. THE COMPLAINT WAS TO RECOVER THE FILES THAT DID NOT COPY TO THEIR SHARE DRIVE. IN THE ADVERSE EVENT FORM SUBMITTED, THE QUESTION "HOW MAY HAVE A NIHON KOHDEN DEVICE CONTRIBUTED TO THE INJURY OR DEATH?" IS ANSWERED "NO". STATING THAT THE NIHON KOHDEN EQUIPMENT WAS NOT THE CAUSE OF THE PATIENT'S DEATH. THIS EQUIPMENT IS USED FOR DIAGNOSTIC PURPOSES, NOT FOR MONITORING OF VITAL SIGNS. NO MALFUNCTION WAS MENTIONED IN THE COMPLAINT OR ADVERSE EVENT FORM.

Description of Event or Problem

THE CUSTOMER REPORTED THAT A PATIENT EXPIRED DURING AN EEG STUDY.

Additional Manufacturer Narrative

STUDIES DID NOT COPY TO SHARE. SERVICE REQUESTED. TROUBLESHOOTING. SERVICE PERFORMED. TROUBLESHOOTING. INVESTIGATION RESULT: THEIR PATIENT PASSED AWAY, THEN THE RN PULLED THE EQUIPMENT PLUG FROM THE WALL CAUSING THE COPY TO FAIL. THIS IS CONSIDERED AND UNGRACEFUL EXIT FOR THE EQUIPMENT. THE COMPLAINT WAS TO RECOVER THE FILES THAT DID NOT COPY TO THEIR SHARE DRIVE. IN THE ADVERSE EVENT FORM SUBMITTED, THE QUESTION "HOW MAY HAVE A NIHON KOHDEN DEVICE CONTRIBUTED TO THE INJURY OR DEATH?" IS ANSWERED "NO". STATING THAT THE NIHON KOHDEN EQUIPMENT WAS NOT THE CAUSE OF THE PATIENT'S DEATH. THIS EQUIPMENT IS USED FOR DIAGNOSTIC PURPOSES, NOT FOR MONITORING OF VITAL SIGNS. NO MALFUNCTION WAS MENTIONED IN THE COMPLAINT OR ADVERSE EVENT FORM. BASED ON THE GIVEN INFORMATION, THIS COMPLAINT RECORD WILL BE CLOSED AS NO FURTHER INVESTIGATION IS NEEDED AT THIS TIME. PATIENT SEX. DATE OF THIS REPORT: DATE USER FACILITY/IMPORTER BECAME AWARE OF THE EVENT. TYPE OF REPORT: APPROXIMATE AGE OF DEVICE. DATE REPORT SENT TO FDA. DATE REPORT SENT TO MANUFACTURER. DATE RECEIVED BY MANUFACTURER. TYPE OF REPORT: IF FOLLOW-UP, WHAT TYPE? ADDITIONAL INFORMATION: CORRECTION. DEVICE EVALUATED BY MANUFACTURER? EVENT PROBLEM AND EVALUATION CODES THE FOLLOWING FIELDS ARE NOT APPLICABLE (N/A) TO THIS REPORT: THE FOLLOWING FIELDS CONTAIN NO INFORMATION (NI), AS ATTEMPTS TO OBTAIN INFORMATION WERE MADE, BUT NOT PROVIDED: AGE AT TIME OF THE EVENT. AGE. DATE OF BIRTH. PATIENT WEIGHT. ETHNICITY. RACE. RELEVANT TESTS/LABORATORY DATA. OTHER RELEVANT HISTORY. SERIAL #.

Additional Manufacturer Narrative

THE CUSTOMER CALLED IN BECAUSE THE RN PULLED THE PLUG ON THE EQUIPMENT, CAUSING THE STUDY AUTOCOPY TO FAIL. THEY WERE REQUESTING ASSISTANCE COPYING THE STUDIES TO THE SHARE FOLDER. THERE IS NO EVIDENCE THAT THE DEATH EVENT IS RELATED TO THE NIHON KOHDEN EQUIPMENT. NIHON KOHDEN CONTINUES TO INVESTIGATE THE REPORTED EVENT. NIHON KOHDEN WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem

THE CUSTOMER REPORTED THAT A PATIENT EXPIRED DURING AN EEG STUDY.