FDA Adverse Event Malfunction Summary report: N

INSPIRATION ELITE COMPRESSOR NEBULIZER SYSTEM

MDR report key: 2096219 · Received April 25, 2011

Report

Report Number
2243193-2011-00002
Event Type
Malfunction
Date Received
April 25, 2011
Date of Event
April 1, 2011
Report Date
April 25, 2011
Manufacturer
RESPIRONICS NEW JERSEY, INC.
Product Code
CAF
PMA / PMN Number
K042655
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NOISE AND START-UP FAILURES DO NOT LEAD TO THESE TYPES OF EVENTS AS THIS IS NOT A LIFE SUSTAINING DEVICE. ALTERNATE METHOD OF THERAPY SHOULD BE AVAILABLE (MDI). RESPIRONICS WILL CONTINUE TO MONITOR COMPLAINTS FOR THIS ISSUE.

Description of Event or Problem · 1

PT STATES HER NEBULIZER TOOK 20 MINS TO START UP. PT HAD TO CALL 911 BECAUSE HER ASTHMA GOT OUT OF CONTROL AND SHE WAS RUSHED TO HOSPITAL. SHE WENT TO (B)(6) HOSPITAL. SHE REMAINED IN HOSPITAL FOR 24 HRS AND WAS RELEASED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INSPIRATION ELITE COMPRESSOR NEBULIZER SYSTEM COMPRESSOR NEBULIZER CAF RESPIRONICS NEW JERSEY, INC. HS456 NA

Patients

Seq Age Sex Outcome Treatment
1 NA Hospitalization