FDA Adverse Event Death Summary report: N

REP DREAMSTATION AUTO BIPAP

MDR report key: 19059816 · Received April 8, 2024

Report

Report Number
2518422-2024-17411
Event Type
Death
Date Received
April 8, 2024
Date of Event
March 21, 2024
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
PMA / PMN Number
K131982
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

H3 OTHER TEXT : DEVICE NOT RETURNED TO MANUFACTURER.

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 INFORMATION ALLEGING NOSE IRRITATION, RESPIRATORY TRACT IRRITATION, DIZZINESS, HEADACHE, NAUSEA, VOMITING, ASTHMA, BREAST CANCER, AND DEATH. THERE WAS NO REPORT OF MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION CAN BE REQUESTED AT THIS TIME. THE MANUFACTURER WAS MADE AWARE OF THIS COMPLAINT THROUGH A REPRESENTATIVE OF THE CUSTOMER. AT THIS TIME, NO FURTHER INVESTIGATION CAN BE PERFORMED. IF ANY ADDITIONAL INFORMATION IS RECEIVED, A FOLLOW UP REPORT WILL BE FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
121669 REP DREAMSTATION AUTO BIPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. UDSX700S11F

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Death| R