FDA Adverse Event Malfunction Summary report: N

DREAMSTATION BIPAP PRO

MDR report key: 13739660 · Received March 11, 2022

Report

Report Number
2518422-2022-08096
Event Type
Malfunction
Date Received
March 11, 2022
Date of Event
July 22, 2020
Report Date
April 28, 2023
Manufacturer
RESPIRONICS, INC
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
RES 88058
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THIS MDR IS BEING SUBMITTED AS PART OF A BATCH SUBMISSION OF COMPLAINTS THAT WERE REASSESSED AS REPORTABLE FOAM DEGRADATION COMPLAINTS; DISCOVERED AS PART OF A RETROSPECTIVE REMEDIATION REVIEW.

Additional Manufacturer Narrative · 0

THE MANUFACTURER WAS CONTACTED IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE / RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. THE MANUFACTURER PREVIOUSLY REPORTED AN ALLEGATION OF AN ISSUE RELATED TO A CPAP DEVICE'S SOUND ABATEMENT FOAM. THE MANUFACTURER RECEIVED INFORMATION ALLEGED VISUALIZATION OF PARTICLES. THERE WAS NO REPORT OF SERIOUS OR PERMANENT HARM OR INJURY. THE DEVICE WAS RETURNED TO THE MANUFACTURER'S SERVICE CENTER FOR FURTHER EVALUATION. THE DEVICE WAS EVALUATED. THERE WAS NO MENTION OF VISUAL FINDINGS TO THE EXTERNAL PART OF THE DEVICE. THE INTERNAL ASPECT OF THE DEVICE WAS INSPECTED. THE DEVICE POWERED ON AND AIRFLOW WAS CONFIRMED. THE DEVICE'S DOWNLOADED LOGS WERE REVIEWED BY THE MANUFACTURER. THERE WERE NO ERRORS FOUND. THE MANUFACTURER CONCLUDES THAT THEY COULD NOT CONFIRM THE CUSTOMER'S ALLEGATION AND THERE WAS NO VISIBLE FOAM DEGRADATION. UNIT WAS SCRAPPED DUE TO 200 MODEL. SECTION H6 UPDATED IN THIS REPORT.

Additional Manufacturer Narrative · 0

THE MANUFACTURER PREVIOUSLY SUBMITTED MDR 2518422-2022-08096-1 WAS INCORRECTLY CREATED. PLEASE DISREGARD THE PREVIOUS MDR.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED INFORMATION ALLEGING AN ISSUE RELATED TO THE BIPAP DEVICE'S SOUND ABATEMENT FOAM. THERE WAS NO REPORT OF PATIENT HARM OR INJURY. THIS ISSUE WAS REPORTED TO THE FDA PER 21 CFR 806. THE DEVICE WILL BE CORRECTED PER RES 88058.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2153760 DREAMSTATION BIPAP PRO VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC DSX600T11

Patients

Seq Age Sex Outcome Treatment
1 Unknown