FDA Adverse Event Malfunction Summary report: N

SERVO-I

MDR report key: 2110983 · Received April 22, 2011

Report

Report Number
8010042-2011-00058
Event Type
Malfunction
Date Received
April 22, 2011
Date of Event
March 25, 2011
Report Date
March 30, 2011
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K062793
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4)

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT AUTO EXTUBATED BUT THE VENTILATOR DID NOT ALARM. THE VENTILATOR CONTINUED CYCLING AND SHOWING A PRESSURE WAVE FLOW WITH EACH CYCLE. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SERVO-I CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1