FDA Adverse Event Other Summary report: N

E360 VENTILATOR

MDR report key: 1966501 · Received January 14, 2011

Report

Report Number
2023050-2011-00002
Event Type
Other
Date Received
January 14, 2011
Date of Event
October 27, 2010
Report Date
December 15, 2010
Manufacturer
NEWPORT MEDICAL INSTRUMENTS, INC.
Product Code
CBK
PMA / PMN Number
K053502
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

REPORTEDLY, THE VENTILATOR WAS CHANGED FROM AC POWERED TO BATTERY POWER WHILE IN USE ON A PATIENT; HOWEVER, THE VENTILATOR DID NOT OPERATE ON BATTERY. IT WAS ALSO REPORTED THAT THERE WAS NO ALARM AT THE TIME OF THE INCIDENT. THE PATIENT WAS MANUALLY VENTILATED UNTIL HE/SHE WAS TRANSFERRED TO A SECOND VENTILATOR. PLEASE NOTE THAT THERE WAS NO SERIOUS INJURY IN THIS CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 E360 VENTILATOR CBK NEWPORT MEDICAL INSTRUMENTS, INC. E360 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention