FDA Adverse Event Malfunction Summary report: N

ACHIEVA

MDR report key: 1001846 · Received February 25, 2008

Report

Report Number
8020893-2008-00069
Event Type
Malfunction
Date Received
February 25, 2008
Date of Event
February 9, 2008
Report Date
February 18, 2008
Manufacturer
GALWAY (RC)
Product Code
CBK
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

NELLCOR PURITAN BENNETT RECEIVED A REPORT THAT THE VENTILATOR FAILED TO CYCLE WHILE BEING USED ON A PT. THE CUSTOMER STATED: THE SETTING FAILURE ALARM WAS ACTIVATED, NURSE NOTICED THAT THE MACHINE STOPPED OPERATING. WHEN THE DOCTOR REBOOTED THE UNIT, IT FUNCTIONED PROPERLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACHIEVA VENTILATOR CBK GALWAY (RC) ACHIEVA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK