FDA Adverse Event
Malfunction
Summary report: N
ESPRIT VENTILATOR
MDR report key: 1083354
·
Received July 28, 2008
Report
- Report Number
- 2031642-2008-00179
- Event Type
- Malfunction
- Date Received
- July 28, 2008
- Date of Event
- July 10, 2008
- Report Date
- July 10, 2008
- Manufacturer
- RESPIRONICS CALIFORNIA, INC.
- Product Code
- CBK
- PMA / PMN Number
- NA
- Removal / Correction Number
- FDA NOTIFIED 02/08/2008
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
NA
Description of Event or Problem · 1
THE INTERNATIONAL DISTRIBUTOR PERFORMED A SNUBBER BOARD REPLACEMENT IN THE VENTILATOR PER FIELD ACTION NOTIFICATION. THE DISTRIBUTOR RETURNED THE SNUBBER BOARD TO THE MFR. THERE WAS NO PROBLEM REPORTED WITH THE VENTILATOR PRIOR TO FIELD ACTION SERVICE. THE VENTILATOR WAS NOT IN USE ON THE PT AND THEREFORE THERE WAS NO PT INVOLVEMENT OR HARM. UPON RECEIPT OF THE SNUBBER BOARD AT THE MFR, VISUAL EXAMINATION REVEALED SIGNS OF DAMAGE TO THE SNUBBER PCB AS A RESULT OF ARCING. DAMAGE TO THE SNUBBER PCB MAY RESULT IN A MALFUNCTION OF THE POWER SUPPLY. MALFUNCTION OF THE POWER SUPPLY DURING USE COULD CAUSE THE VENTILATOR TO SHUT DOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ESPRIT VENTILATOR | VENTILATOR, CONTINUOUS | CBK | RESPIRONICS CALIFORNIA, INC. | V1000 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA |