FDA Adverse Event Malfunction Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 21271299 · Received January 30, 2025

Report

Report Number
2518422-2025-009532
Event Type
Malfunction
Date Received
January 30, 2025
Date of Event
December 26, 2024
Report Date
January 7, 2026
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
UDI-DI
00606959051515
PMA / PMN Number
K131982
Removal / Correction Number
Z-1974-2021
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

THIS MDR WAS PREVIOUSLY REPORTED UNDER MFR 2518422-2025-100980 AND IS THEREFORE A DUPLICATE.

Additional Manufacturer Narrative · 0

THE MANUFACTURER REPORTED ON THIS DEVICE IN MDR 2518422-2025-009532 IN ERROR. AT THIS TIME OF INVESTIGATION, IT HAS BEEN DETERMINED THAT ALL FURTHER REPORTING ACTIVITIES WILL BE CARRIED OUT IN SRC (B)(4). SO, MDR 2518422-2025-009532 IS A DUPLICATE OF SRC (B)(4).

Description of Event or Problem · 0

THE MANUFACTURER WAS CONTACTED IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE/RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. THE MANUFACTURER RECEIVED INFORMATION ALLEGING VISUALIZATION OF PARTICLES. THERE WAS NO REPORT OF MEDICAL INTERVENTION. THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER. AT THIS TIME, NO FURTHER INVESTIGATION CAN BE REQUESTED. IF ANY ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
682130 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500H11C 00606959051515

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown