FDA Adverse Event Other Summary report: N

VENTILATOR, CONTINUOUS, FACILITY USE

MDR report key: 2163595 · Received June 6, 2011

Report

Report Number
2518422-2011-00060
Event Type
Other
Date Received
June 6, 2011
Date of Event
March 31, 2011
Report Date
May 9, 2011
Manufacturer
RESPIRONICS, INC.
Product Code
CBK
PMA / PMN Number
K083526
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MFR RECEIVED INFO ALLEGING A PT'S BLOOD OXYGEN SATURATION DECREASED WHEN A VENTILATOR THAT WAS PROVIDING THERAPY DID NOT DELIVER THE SET NUMBER OF BREATHS. THE PT WAS PLACED ON ANOTHER DEVICE AND THERE WAS NO REPORTED SERIOUS HARM OR INJURY. THE MFR'S INVESTIGATION IS CURRENTLY ONGOING, AND A F/U REPORT WILL BE FILED WHEN THE INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VENTILATOR, CONTINUOUS, FACILITY USE TRILOGY 100 CBK RESPIRONICS, INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1 Other