FDA Adverse Event Malfunction Summary report: N

BIPAP A40 PRO

MDR report key: 20198660 · Received September 12, 2024

Report

Report Number
2518422-2024-58400
Event Type
Malfunction
Date Received
September 12, 2024
Date of Event
May 17, 2024
Report Date
September 12, 2024
Manufacturer
RESPIRONICS, INC.
Product Code
MNT
UDI-DI
00606959059405
PMA / PMN Number
K121623
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THE BIPAP A40 PRO MODEL# CAX3100S12 IS SUBSTANTIALLY SIMILAR TO THE BIPAP A40 1111177 AND WILL BE REPORTED IN THE UNITED STATES UNDER BIPAP A40 PRO, 501K NUMBER: K121623.

Description of Event or Problem · 0

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR INOPERATIVE CONDITION OCCURRED. THERE WAS NO HARM OR INJURY REPORTED. UPON FURTHER REVIEW, THIS COMPLAINT HAS BEEN DEEMED AS A REPORTABLE EVENT. THE MANUFACTURER'S INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
505811 BIPAP A40 PRO VENTILATOR, CONTINUOUS, NON-LIFE-SUPPORTING MNT RESPIRONICS, INC. CAX3100S12 00606959059405

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown