BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SERVO VENTILATOR 900

    MDR report key: 1761149 · Received July 15, 2010

    Report

    Report Number
    8010042-2010-00150
    Event Type
    Malfunction
    Date Received
    July 15, 2010
    Date of Event
    May 28, 2010
    Report Date
    June 22, 2010
    Manufacturer
    MAQUET CRITICAL CARE AB
    Product Code
    CBK
    PMA / PMN Number
    K893786
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE VENTILATOR STOPPED WORKING WHILE IT WAS CONNECTED TO A PT. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SERVO VENTILATOR 900 CBK MAQUET CRITICAL CARE AB

    Patients

    Seq Age Sex Outcome Treatment
    1