FDA Adverse Event Malfunction Summary report: N

DS2ADV AUTO CPAP

MDR report key: 17938034 · Received October 16, 2023

Report

Report Number
2518422-2023-26714
Event Type
Malfunction
Date Received
October 16, 2023
Date of Event
December 9, 2021
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
PMA / PMN Number
K200480
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

CORRECTIVE AND PREVENTATIVE ACTIONS HAVE BEEN OPENED BY THE MANUFACTURER TO ADDRESS THE WATER INGRESS IDENTIFIED UPON INVESTIGATION.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED INFORMATION ALLEGING THE DREAMSTATION 2 ADVANCED AUTO CPAP DEVICE STOPPED WORKING AND NOT POWERING ON. THERE WAS NO REPORT OF PATIENT HARM OR INJURY. THE DEVICE WAS RETURNED TO THE MANUFACTURER'S PRODUCT INVESTIGATION LABORATORY FOR EVALUATION. EXTERNAL AND INTERNAL INSPECTION OF THE DEVICE AND OBSERVED THE FOLLOWING: PIL WAS UNABLE TO POWER ON DEVICE, NOTED THERMAL ODOR WHEN AC POWER APPLIED. THE ERROR LOG WAS UNAVAILABLE AND CARE ORCHESTRATOR DATA WAS ALSO UNAVAILABLE DUE TO THE THERMAL DAMAGE OF THE PCA. PIL THEN DISASSEMBLED THE DEVICE AND FOUND THE THERMAL DAMAGE ON THE PCA, UI PANEL AND THE ISO PORT DUE TO WATER INGRESS ON THE PCA. THIS IS A KNOWN ISSUE INVESTIGATED UNDER CAPA 1299367. PIL CONCLUDED THAT THERMAL ISSUE CAUSED THE DEVICE TO SHUT DOWN. RISK TAGS (ER 2233162, REV 8) ASSOCIATED WITH THESE MODES OF FAILURE COULD INCLUDE: FIRE02, FIRE04. THE RESULTS OF THIS INVESTIGATION DO NOT IMPACT THE CALCULATED RISKS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2120657 DS2ADV AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX520H11C

Patients

Seq Age Sex Outcome Treatment
1 Unknown