FDA Adverse Event Injury Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 15519814 · Received September 30, 2022

Report

Report Number
2518422-2022-84844
Event Type
Injury
Date Received
September 30, 2022
Date of Event
February 4, 2021
Report Date
June 1, 2023
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
RES 88058
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, 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 RECEIVED A VOLUNTARY MEDWATCH (MW-5111635) IN WHICH SINUS INFECTIONS WERE ALLEGED BY THE PATIENT. MEDICAL INTERVENTION WAS PRESCRIPTION ANTIBIOTICS AND SURGERY.. REPEATED ATTEMPTS TO HAVE THE DEVICE AND COMPONENTS RETURNED FOR EVALUATION AND INVESTIGATION WERE UNSUCCESSFUL. THE MANUFACTURER BELIEVES THEY WILL BE UNABLE TO GATHER ADDITIONAL INFORMATION. THE MANUFACTURER IS SUBMITTING A FINAL REPORT AT THIS TIME. IF PERTINENT INFORMATION BECOMES AVAILABLE TO THE MANUFACTURER AT A LATER DATE, AN ADDENDUM TO THIS FINAL REPORT WILL BE FILED. SECTION H6 UPDATED IN THIS REPORT.

Description of Event or Problem · 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 RECEIVED A VOLUNTARY MEDWATCH (MW-5111635) IN WHICH SINUS INFECTIONS WERE ALLEGED BY THE PATIENT. MEDICAL INTERVENTION WAS PRESCRIPTION ANTIBIOTICS AND SURGERY. 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
2335764 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500T11C

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other