FDA Adverse Event Malfunction Summary report: N

SERVO-I BASE UNIT

MDR report key: 21891083 · Received April 23, 2025

Report

Report Number
8010042-2025-0000634
Event Type
Malfunction
Date Received
April 23, 2025
Date of Event
April 15, 2025
Report Date
April 23, 2025
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K123149
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE UDI INFORMATION IS NOT AVAILABLE SINCE THE DEVICE WAS MANUFACTURED BEFORE 2015.

Additional Manufacturer Narrative · 0

ON-SITE INVESTIGATION WAS PERFORMED BY OUR FIELD SERVICE ENGINEER. THE CLAIMED ISSUE WAS REPRODUCED DURING TROUBLESHOOTING. ALSO TECHNICAL ERROR 29, 10001 AND 24 WERE GENERATED BY THE DEVICE. TECHNICAL ERROR 3 IS A POWER ERROR WHICH INFORM ABOUT SITUATION WHERE +12 V TOO LOW, I.E. < +10.8 V, A POWER SYSTEM RESTART MIGHT BE NECESSARY TO RESET POWER RELATED ALARMS. TO RESTART, SWITCH OFF THE SYSTEM AND DISCONNECT THE MAINS POWER SUPPLY. ACCORDING TO INFORMATION RECEIVED IN THE SERVICE REPORT, THE MONITORING PRINTED CIRCUIT BOARD WAS DEFECTIVE. DEVICE LOGS WERE NOT PROVIDED. THE CAUSE OF THE CLAIMED ISSUE IN THIS CUSTOMER PRODUCT COMPLAINT HAS BEEN DETERMINED. THE REPORTED ISSUE WAS RELATED TO MONITORING PRINTED CIRCUIT BOARD.

Description of Event or Problem · 0

DURING THE INSPECTION OF THE VENTILATOR, IT WAS DISCOVERED THAT TECHNICAL ERROR CODE INDICATING POWER ERROR WAS GENERATED. THERE WAS NO PATIENT HARM. MANUFACTURER'S REF. #: (B)(4).

Description of Event or Problem · 0

MANUFACTURER'S REF. #: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
515545 SERVO-I BASE UNIT VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB 6487800

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown