FDA Adverse Event Other Summary report: N

VENTILATOR, CONTINUOUS, FACILITY USE

MDR report key: 2358014 · Received November 30, 2011

Report

Report Number
2518422-2011-00178
Event Type
Other
Date Received
November 30, 2011
Date of Event
November 3, 2011
Report Date
November 3, 2011
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE MFR RECEIVED INFO ALLEGING A VENTILATOR FAILED TO AUDIBLY ALARM WHEN A PT PULLED HIS TRACHEOSTOMY TUBE OUT. A CAREGIVER WITNESSED THE EVENT AND INTERVENED. THERE WAS NO PT HARM OR INJURY. THE MFR'S INVESTIGATION OF THIS REPORTED EVENT IS CURRENTLY ON-GOING. A FOLLOW-UP 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 1 YR Required Intervention