FDA Adverse Event
Injury
Summary report: N
SERVO U VENTILATOR
MDR report key: 19104355
·
Received April 12, 2024
Report
- Report Number
- MW5153818
- Event Type
- Injury
- Date Received
- April 12, 2024
- Date of Event
- April 10, 2024
- Report Date
- April 10, 2024
- Manufacturer
- GETINGE GROUP LOGISTICS AMERICA, LLC
- Product Code
- CBK
- Adverse Event
- Yes
- Report Source
- Voluntary report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
PATIENT IS INTUBATED ON A SERVO U VENTILATOR. SERVO U BEGAN TO ALARM FLASHING A HIGH PRIORITY ALARM. THE ALARM WAS "TECHNICAL ERROR 55". THE PATIENT HAD TO BE REMOVED FROM THE VENTILATOR AND BAGGED WITH A BAG VALVE MASK. ANOTHER VENTILATOR HAD TO BE SECURED, SET UP, AND THE PATIENT WAS PLACED ON IT. THIS HAS OCCURRED WITH THIS EXACT VENTILATOR PREVIOUSLY. THE SERVICE REPRESENTATIVE CAME OUT PREVIOUSLY AND CLEARED THE VENTILATOR PROVIDING A WRITTEN REPORT THAT IT WAS SAFE TO USE ON PATIENTS. THIS HAS OCCURRED ON FOUR OCCASIONS. REFERENCE REPORT #MW5153819, #MW5153820, #MW5153821.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1024408 | SERVO U VENTILATOR | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | GETINGE GROUP LOGISTICS AMERICA, LLC | SERVO U |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 61 YR | Male | Required Intervention |