FDA Adverse Event Malfunction Summary report: N

840 VENTILATOR

MDR report key: 2802569 · Received October 19, 2012

Report

Report Number
8020893-2012-01000
Event Type
Malfunction
Date Received
October 19, 2012
Date of Event
September 21, 2012
Report Date
September 21, 2012
Manufacturer
COVIDIEN, FORMERLY NELLCOR
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE 840 VENTILATOR WAS INOPERABLE. THERE WAS NO PT INVOLVEMENT. COVIDIEN INSPECTED THE DEVICE AND REPLACED THE GRAPHICAL USER INTERFACE CABLE. THE VENTILATOR PASSED ALL TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 840 VENTILATOR VENTILATOR CBK COVIDIEN, FORMERLY NELLCOR 840

Patients

Seq Age Sex Outcome Treatment
1