BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ESPRIT VENTILATOR

    MDR report key: 2023921 · Received March 18, 2011

    Report

    Report Number
    2031642-2011-00061
    Event Type
    Malfunction
    Date Received
    March 18, 2011
    Date of Event
    February 19, 2011
    Report Date
    February 19, 2011
    Manufacturer
    RESPIRONICS CALIFORNIA, INC.
    Product Code
    CBK
    PMA / PMN Number
    K981072
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THE VENTILATOR SHUT DOWN AND ALARMED UPON CHANGING THE POWER OUTLET IT WAS PLUGGED INTO, AND THEN DISPLAYED VENT INOP. THE CUSTOMER REPORTED THE UNIT WAS IN USE ON A PATIENT AND THERE WAS NO PATIENT HARM. THE MANUFACTURER'S SERVICE TECHNICIAN REPORTED THE DEVICE DISPLAYED VENT INOP UPON START UP. THE SERVICE TECHNICIAN REPLACED THE POWER SUPPLY TO ADDRESS THE FINDING. EXTENDED SELF TESTING AND APPLICABLE FINAL TESTING WAS COMPLETED AND PASSED PER OPERATING SPECIFICATIONS. ANALYSIS OF THE POWER SUPPLY REVEALED A MALFUNCTION THAT MAY RESULT IN THE UNIT SHUTTING DOWN DURING OPERATION WITH AN ACTIVE BACKUP ALARM WHEN AC POWER IS RESTORED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ESPRIT VENTILATOR VENTILATOR, CONTINUOUS CBK RESPIRONICS CALIFORNIA, INC. V1000 NA

    Patients

    Seq Age Sex Outcome Treatment
    1