FDA Adverse Event Injury Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 20492234 · Received October 21, 2024

Report

Report Number
2518422-2024-63928
Event Type
Injury
Date Received
October 21, 2024
Date of Event
January 4, 2024
Report Date
October 21, 2024
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
UDI-DI
00606959424159
PMA / PMN Number
K131982
Removal / Correction Number
Z-1974-2021
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
003

Narratives

Description of Event or Problem · 0

THE MANUFACTURER WAS CONTACTED IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE/RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. THE MANUFACTURER RECEIVED INFORMATION THAT THE PATIENT ALLEGING NOSE IRRITATION, RESPIRATORY TRACT IRRITATION, DIZZINESS, HEADACHE, HYPERSENSITIVITY, ASTHMA (NEW OR WORSENING),INFLAMMATORY RESPONSE, LUNG DISEASE, REDUCED CARDIOPULMONARY RESERVE, SCAR TISSUE ON LUNGS, FIBROSIS (ITF), HEART FAILURE DUE TO LUNG DAMAGE AND OTHER. THERE WAS NO REPORT OF MEDICAL INTERVENTION. THE MANUFACTURER WAS MADE AWARE OF THIS COMPLAINT THROUGH A REPRESENTATIVE OF THE CUSTOMER. AFTER THE MULTIPLE ATTEMPTS TO HAVE THE DEVICE AND COMPONENTS RETURNED FOR EVALUATION AND INVESTIGATION WERE UNSUCCESSFUL. THE MANUFACTURER BELIEVES THEY WILL BE UNABLE TO GATHER ADDITIONAL INFORMATION. IF PERTINENT INFORMATION BECOMES AVAILABLE TO THE MANUFACTURER AT A LATER DATE, AN ADDENDUM TO THIS FINAL REPORT WILL BE FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2228700 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500H11 00606959424159

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other