FDA Adverse Event
Malfunction
Summary report: N
REMSTAR AUTO A-FLEX
MDR report key: 22682573
·
Received July 31, 2025
Report
- Report Number
- 2518422-2025-108542
- Event Type
- Malfunction
- Date Received
- July 31, 2025
- Date of Event
- July 25, 2025
- Report Date
- September 24, 2025
- Manufacturer
- RESPIRONICS, INC.
- Product Code
- BZD
- UDI-DI
- 00606959030725
- PMA / PMN Number
- K131982
- Removal / Correction Number
- Z-1974-2021
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- 003
Narratives
Additional Manufacturer Narrative · 0
ON PREVIOUSLY SUBMITTED REPORT, REPORTER COUNTRY IN BOX E WAS INCORRECT. SECTION TYPE OF REPORTER COUNTRY IN BOX E HAS BEEN UPDATED/CORRECTED IN THIS REPORT.
Description of Event or Problem · 0
A DEVICE WAS RETURNED TO A THIRD PARTY SERVICE CENTER IN REFERENCE TO THE VOLUNTARY FIELD SAFETY NOTICE / RECALL NOTIFICATION RELATED TO THE SOUND ABATEMENT FOAM IN CERTAIN CPAP, BIPAP, AND MECHANICAL VENTILATOR DEVICES. DURING THE EVALUATION OF THE DEVICE AT THE THIRD PARTY SERVICE CENTER, THE DEVICE WAS VISUALLY INSPECTED/SCRAPPED AND FOUND EVIDENCE OF FOAM DEGRADATION. DURING THE EVALUATION, FOAM PARTICLES WERE VISIBLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 221695 | REMSTAR AUTO A-FLEX | VENTILATOR, NON-CONTINUOUS (RESPIRATOR) | BZD | RESPIRONICS, INC. | FR565S | 00606959030725 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |