FDA Adverse Event Malfunction Summary report: N

DREAMSTATION

MDR report key: 21225883 · Received January 23, 2025

Report

Report Number
2518422-2025-101147
Event Type
Malfunction
Date Received
January 23, 2025
Date of Event
January 8, 2025
Report Date
December 2, 2025
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
PMA / PMN Number
K131982
Removal / Correction Number
Z-1974-2021
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

A DEVICE WAS RETURNED TO A THIRD PARTY SERVICE CENTER/MANUFACTURER IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE / RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. DURING THE EVALUATION OF THE DEVICE AT THE THIRD PARTY SERVICE CENTER, THE DEVICE WAS VISUALLY INSPECTED AND FOUND EVIDENCE OF FOAM DEGRADATION. DURING THE EVALUATION, FOAM PARTICLES WERE OBSERVED. THE DEVICE WAS SCRAPPED. UPON REVIEW, IT WAS DETERMINED THIS REPORT IS A DUPLICATE OF MFR 2518422-2025-027037. ALL REPORTING WILL BE COMPLETED ON MFR 2518422-2025-027037. PLEASE DISREGARD MFR 2518422-2025-101147.

Description of Event or Problem · 0

A DEVICE WAS RETURNED TO A THIRD PARTY SERVICE CENTER/MANUFACTURER IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE / RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. DURING THE EVALUATION OF THE DEVICE AT THE THIRD PARTY SERVICE CENTER, THE DEVICE WAS VISUALLY INSPECTED AND FOUND EVIDENCE OF FOAM DEGRADATION. DURING THE EVALUATION, FOAM PARTICLES WERE OBSERVED. THE DEVICE WAS SCRAPPED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
662341 DREAMSTATION VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500T11C

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown