FDA Adverse Event Malfunction Summary report: N

ESPRIT VENTILATOR

MDR report key: 1212989 · Received October 29, 2008

Report

Report Number
2031642-2008-00216
Event Type
Malfunction
Date Received
October 29, 2008
Date of Event
October 3, 2008
Report Date
October 3, 2008
Manufacturer
RESPIRONICS CALIFORNIA, INC.
Product Code
CBK
PMA / PMN Number
K981072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT WHEN THE AUDIBLE ALARM ACTIVATED ON THE VENTILATOR, THE FACILITY REMOTE NURSE CALL DID NOT ALARM. THE VENTILATOR WAS IN USE ON A PATIENT. THE CUSTOMER REPORTED THERE WAS NO PATIENT HARM. THE MANUFACTURER'S SERVICE TECHNICIAN WAS ABLE TO DUPLICATE THE CUSTOMER REPORTED PROBLEM. THE SERVICE TECHNICIAN REPLACED THE MAIN PRINTED CIRCUIT BOARD (PCB) TO CORRECT THE PROBLEM. EXTENDED SELF TESTING (EST) AND PERFORMANCE VERIFICATION TESTING WAS COMPLETED AND ALL TESTS PASSED PER OPERATING SPECIFICATIONS.

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