FDA Adverse Event Malfunction Summary report: N

LTV

MDR report key: 2072039 · Received April 20, 2011

Report

Report Number
2031702-2011-00080
Event Type
Malfunction
Date Received
April 20, 2011
Report Date
April 20, 2011
Manufacturer
CAREFUSION 203, INC.
Product Code
CBK
PMA / PMN Number
K051767
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
SERVICE AND TESTING PERSONNEL

Narratives

Additional Manufacturer Narrative · 1

NA

Description of Event or Problem · 1

IT WAS REPORTED BY THE FIELD SERVICE CENTER THAT THE VENTILATOR RESET TWO TIMES. THE VENTILATOR WAS ALSO MAKING A WHINING NOISE. IT IS UNK IF THE VENTILATOR AUDIBLY ALARMED WHEN THE REPORTED PROBLEM OCCURRED. THE VENTILATOR WAS NOT CONNECTED TO A PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LTV VENTILATOR, CONTINUOUS / CBK CBK CAREFUSION 203, INC. LTV 1000 NA

Patients

Seq Age Sex Outcome Treatment
1 NA