FDA Adverse Event Injury Summary report: N

HT70 VENTILATOR

MDR report key: 2842166 · Received November 15, 2012

Report

Report Number
2023050-2012-00269
Event Type
Injury
Date Received
November 15, 2012
Date of Event
October 18, 2012
Report Date
October 30, 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

THOUGH REQUESTED, PT INFO WAS NOT PROVIDED.

Description of Event or Problem · 1

REPORTEDLY, DURING PT USE, "BACKUP BATTERY FAILURE" AND "BACKUP BATTERY LOW" ALARM OCCURRED WHEN THE AC CABLE WAS REMOVED FROM THE VENTILATOR. THE PT WAS MANUALLY VENTILATED AND SWITCHED TO ANOTHER VENTILATOR. THERE WERE NO ADVERSE PT EFFECTS REPORTED.

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