FDA Adverse Event Malfunction Summary report: N

DREAMSTATION AUTO CPAP

MDR report key: 21357228 · Received February 11, 2025

Report

Report Number
2518422-2025-014433
Event Type
Malfunction
Date Received
February 11, 2025
Date of Event
August 22, 2022
Report Date
May 9, 2025
Manufacturer
RESPIRONICS, INC.
Product Code
BZD
UDI-DI
00606959424197
PMA / PMN Number
K131982
Removal / Correction Number
Z-19974-2021
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

IN THIS REPORT, BOX E HAS BEEN UPDATED/CORRECTED.

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 PATIENT ALLEGES VISUALIZATION OF PARTICLES IN DEVICE. THERE IS NO ALLEGATION OF SERIOUS OR PERMANENT HARM OR INJURY. NO MEDICAL INTERVENTION WAS REQUIRED BY THE PATIENT. THE MANUFACTURER'S INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
965267 DREAMSTATION AUTO CPAP VENTILATOR, NON-CONTINUOUS (RESPIRATOR) BZD RESPIRONICS, INC. DSX500T11 00606959424197

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown