FDA Adverse Event Malfunction Summary report: N

DREAMSTATION CPAP PRO

MDR report key: 14239952 · Received April 28, 2022

Report

Report Number
2518422-2022-15615
Event Type
Malfunction
Date Received
April 28, 2022
Date of Event
March 31, 2022
Report Date
January 20, 2023
Manufacturer
RESPIRONICS INC
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
RES88058
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

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 RECEIVED INFORMATION ALLEGING AN ISSUE RELATED TO A CPAP DEVICE'S SOUND ABATEMENT FOAM. THE PATIENT ALLEGED VISUALIZATION OF PARTICLES THERE WAS NO REPORT OF HARM OR INJURY. DESPITE MULTIPLE ATTEMPTS ON 11/15/2022, 11/18/2022, 11/23/2022 THE DEVICE HAS NOT YET RETURNED TO THE MANUFACTURER FOR EVALUATION. AT THIS TIME, NO FURTHER INVESTIGATION CAN BE PERFORMED. IF ANY ADDITIONAL INFORMATION IS RECEIVED, A FOLLOW UP REPORT WILL BE FILED.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED INFORMATION ALLEGING AN ISSUE RELATED TO A CPAP DEVICE'S SOUND ABATEMENT FOAM. THE PATIENT ALLEGED VISUALIZATION OF PARTICLES THERE WAS NO REPORT OF HARM OR INJURY. THE MANUFACTURER'S INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
104757 DREAMSTATION CPAP PRO VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS INC DSX400H11

Patients

Seq Age Sex Outcome Treatment
1 Unknown