FDA Adverse Event Injury Summary report: N

SULLIVAN VPAPII - AUSTRALIA.

MDR report key: 1981045 · Received February 3, 2011

Report

Report Number
3004604967-2011-00009
Event Type
Injury
Date Received
February 3, 2011
Date of Event
January 1, 2011
Report Date
February 3, 2011
Manufacturer
RESMED LTD.
Product Code
BZD
PMA / PMN Number
K961783
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PT WAS KEPT IN THE HOSPITAL OVERNIGHT FOR OBSERVATION. WHILE UNDER OBSERVATION, THE PT WAS ADMINISTERED SOME OXYGEN THERAPY AND DISCHARGED THE NEXT DAY. WITHIN A COUPLE OF DAYS AFTER THE EVENT, THE PT WAS NO LONGER EXPERIENCING ANY CLINICAL SIGNS FROM THIS EVENT. RESMED HAS CONDUCTED AN EVAL OF THE DEVICE. AN INTERNAL INSPECTION FOUND MINOR CHARRING AROUND A FAULTY CAPACITOR ON THE PSU.

Description of Event or Problem · 1

IT WAS REPORTED TO RESMED (B)(4) THAT A VPAP II EMITTED SMOKE WHILE IN USE. THE PT WAS ADMITTED TO HOSPITAL WITH SYMPTOMS OF NAUSEA AND TIGHTENING OF HIS CHEST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SULLIVAN VPAPII - AUSTRALIA. BZD RESMED LTD. 21058

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization