FDA Adverse Event
Malfunction
Summary report: N
TRILOGY EVO, BRAZIL
MDR report key: 20164322
·
Received September 6, 2024
Report
- Report Number
- 2518422-2024-100398
- Event Type
- Malfunction
- Date Received
- September 6, 2024
- Date of Event
- August 8, 2024
- Manufacturer
- RESPIRONICS, INC.
- Product Code
- CBK
- PMA / PMN Number
- K181166
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- BR
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
THE TRILOGY EVO, BRAZIL (BR2110X18B) IS SUBSTANTIALLY SIMILAR TO THE TRILOGY EVO (DS2100X11B) AND WILL BE REPORTED IN THE UNITED STATES UNDER TRILOGY EVO 501K NUMBER: K181166..
Description of Event or Problem · 0
A VENTILATOR WAS RETURNED TO THE MANUFACTURER'S FACTORY AUTHORIZED SERVICE CENTER FOR SERVICE. THERE WAS NO ALLEGATION OF DEVICE MALFUNCTION. THE DEVICE WAS NOT IN PATIENT USE. DURING THE EVALUATION OF THE DEVICE AT THE MANUFACTURER'S SERVICE CENTER, IT WAS NOTED THAT THE DEVICE'S FLOW SENSOR FAILED. THE DEVICE'S FLOW SENSOR WAS REPLACED TO ADDRESS THE ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1226617 | TRILOGY EVO, BRAZIL | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS, INC. | BR2110X18B |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |