FDA Adverse Event
Malfunction
Summary report: N
ESPRIT VENTILATOR
MDR report key: 1910192
·
Received November 30, 2010
Report
- Report Number
- 2031642-2010-00324
- Event Type
- Malfunction
- Date Received
- November 30, 2010
- Date of Event
- November 3, 2010
- Report Date
- November 3, 2010
- Manufacturer
- RESPIRONICS CALIFORNIA, INC.
- Product Code
- CBK
- PMA / PMN Number
- K981072
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
POWER SUPPLY.
Description of Event or Problem · 1
THE INTERNATIONAL DISTRIBUTOR REPORTED THE VENTILATOR WOULD NOT OPERATE ON AC POWER. THE VENTILATOR WAS NOT IN USE, THEREFORE THERE WAS NO PATIENT HARM OR INVOLVEMENT. THE SERVICE TECHNICIAN REPLACED THE POWER SUPPLY TO CORRECT THE REPORTED PROBLEM. IF A FAILURE OF THE POWER SUPPLY OCCURS DURING USE AND THE VENTILATOR SHUTS DOWN, AN AUDIBLE POWER FAIL ALARM WILL ACTIVATE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | ESPRIT VENTILATOR | VENTILATOR, CONTINUOUS | CBK | RESPIRONICS CALIFORNIA, INC. | V1000 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |