FDA Adverse Event Other Summary report: N

STELLAR 100 - UK

MDR report key: 2718733 · Received August 24, 2012

Report

Report Number
3004604967-2012-00034
Event Type
Other
Date Received
August 24, 2012
Date of Event
July 20, 2012
Report Date
August 23, 2012
Manufacturer
RESMED GERMANY INC.
Product Code
MNT
PMA / PMN Number
K103167
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION OF THE RETURNED DEVICE FOUND THE SYSTEM FAILURE WAS TRIGGERED BY AN OVER-PRESSURE SAFETY CONDITION. THIS LIKELY OCCURRED WHEN THE PT DISCONNECTED AND RECONNECTED THE HIGH IMPEDANCE PT CIRCUIT DURING THERAPY. THE DEVICE ALARM OPERATED AS INTENDED TO NOTIFY THE PT/USER OF THE FAILURE. NO PERMANENT INJURY WAS REPORTED AS RESULT OF THIS INCIDENT.

Description of Event or Problem · 1

IT WAS REPORTED TO RESMED UK THAT A DEVICE HAD A SYSTEM FAILURE 6 AND FAILED TO VENTILATE, AT WHICH POINT THE PT REQUIRED BAGGING (MANUAL VENTILATION).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STELLAR 100 - UK MNT RESMED GERMANY INC. 24155

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention