FDA Adverse Event
Malfunction
Summary report: N
VOCSN
MDR report key: 21867229
·
Received April 18, 2025
Report
- Report Number
- 3013095415-2025-00345
- Event Type
- Malfunction
- Date Received
- April 18, 2025
- Date of Event
- March 13, 2025
- Report Date
- April 18, 2025
- Manufacturer
- VENTEC LIFE SYSTEMS, INC
- Product Code
- CBK
- UDI-DI
- 00855573007211
- PMA / PMN Number
- K162877
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- 505
Narratives
Additional Manufacturer Narrative · 0
H6: THE DEVICE WAS NOT RETURNED TO VENTEC FOR AN EVALUATION. THE DEVICE WAS FURTHER EVALUATED BY THE AUTHORIZED SERVICE PROVIDER (ASP) WHERE THE REPORTED ISSUE OF IT DELIVERING LOW FIO2 (FRACTION OF INSPIRED OXYGEN) WAS CONFIRMED. THE ASP REPLACED THE OAX BOARD (CIRCUIT BOARD) TO RESOLVE THE REPORTED ISSUE. PROPER DEVICE OPERATION WAS THEN CONFIRMED THROUGH FUNCTIONAL AND PERFORMANCE TESTING. THE INVESTIGATION DETERMINED THE CAUSE OF THE REPORTED ISSUE TO BE THE CIRCUIT BOARD.
Description of Event or Problem · 0
AN AUTHORIZED SERVICE PROVIDER (ASP), CONTACTED VENTEC TO REPORT THAT THE DEVICE WAS PROVIDING INACCURATE FIO2 (FRACTION OF INSPIRED OXYGEN) READINGS. THERE WERE NO REPORTS OF PATIENT USE ASSOCIATED WITH THE REPORTED ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 20423 | VOCSN | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | VENTEC LIFE SYSTEMS, INC | V+C+PRO, JAPANESE | 00855573007211 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |