FDA Adverse Event Injury Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 19337862 · Received May 16, 2024

Report

Report Number
2518422-2024-29012
Event Type
Injury
Date Received
May 16, 2024
Date of Event
October 9, 2023
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
Z-1974-2021
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

H3 OTHER TEXT : DEVICE NOT RETURNED TO THE 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 OF EYE IRRITATION, SKIN IRRITATION, RESPIRATORY TRACT IRRITATION, DIZZINESS AND/OR HEADACHE, HYPERSENSITIVITY, NAUSEA / VOMITING, ASTHMA (NEW OR WORSENING) INFLAMMATORY RESPONSE. OTHER RESPIRATORY ISSUES, RESPIRATORY FAILURE, & ACUTE RESPIRATORY DISTRESS SYSTEM (ARDS). 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
744083 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500H11C

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other