FDA Adverse Event
Injury
Summary report: N
HT70 VENTILATOR
MDR report key: 2850107
·
Received November 27, 2012
Report
- Report Number
- 2023050-2012-00301
- Event Type
- Injury
- Date Received
- November 27, 2012
- Date of Event
- October 22, 2012
- Report Date
- October 31, 2012
- Manufacturer
- NEWPORT MEDICAL INSTRUMENTS
- 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, NO PT INFO WAS PROVIDED.
Description of Event or Problem · 1
DURING PT USE, WHEN CONNECTING THE AC CABLE, A 'BACKUP BATTERY FAILURE' ALARM OCCURRED. THE PT WAS AMBU BAGGED AND SWITCHED TO ANOTHER VENTILATOR. 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 | HT70 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |