FDA Adverse Event Malfunction Summary report: N

SERVO-S

MDR report key: 2223428 · Received May 20, 2011

Report

Report Number
8010042-2011-00083
Event Type
Malfunction
Date Received
May 20, 2011
Date of Event
May 7, 2011
Report Date
May 9, 2011
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K041223
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR FAILED THE INTERNAL LEAKAGE TEST, THE PRESSURE TRANSDUCER TEST, THE SAFETY VALVE TEST AND THE FLOW TRANSDUCER TEST DURING PRE-USE CHECK. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SERVO-S CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1