FDA Adverse Event Injury Summary report: N

HT70 VENTILATOR

MDR report key: 2792094 · Received October 11, 2012

Report

Report Number
2023050-2012-00208
Event Type
Injury
Date Received
October 11, 2012
Date of Event
September 6, 2012
Report Date
September 20, 2012
Manufacturer
NEWPORT MEDICAL INSTRUMENTS, INC.
Product Code
CBK
PMA / PMN Number
K090888
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ALTHOUGH REQUESTED, PT INFO WAS NOT PROVIDED.

Description of Event or Problem · 1

DURING PT USE, A 'SWITCHED TO BACKUP BATTER' ALARM OCCURRED ON BATTERY OPERATION. THE BATTERY LED DID NOT LIGHT ANY COLORS. THE PT WAS AMBU BAGGED AND SWITCHED TO ANOTHER VENTILATOR. THIS ISSUE WAS SOLVED BY REPLACING THE POWER PAC BATTERY. NO PERMANENT INJURY WAS REPORTED IN THIS CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HT70 VENTILATOR CBK, NOU CBK NEWPORT MEDICAL INSTRUMENTS, INC. HT70

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention