FDA Adverse Event
Malfunction
Summary report: N
LTV
MDR report key: 2083335
·
Received April 14, 2011
Report
- Report Number
- 2031702-2011-00074
- Event Type
- Malfunction
- Date Received
- April 14, 2011
- Report Date
- April 14, 2011
- Manufacturer
- CAREFUSION 203, INC.
- Product Code
- CBK
- PMA / PMN Number
- NA
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
NA
Description of Event or Problem · 1
IT WAS REPORTED THAT DURING BENCH TESTING THE VENTILATOR STARTED CYCLING ON AND OFF WITH AUDIBLE ALARMS. THE VENTILATOR WAS NOT CONNECTED TO A PT WHEN THE REPORTED PROBLEM OCCURRED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LTV | VENTILATOR, CONTINUOUS / CBK | CBK | CAREFUSION 203, INC. | LTV 950 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA |