FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 2850191
·
Received November 21, 2012
Report
- Report Number
- 2518422-2012-02319
- Event Type
- Malfunction
- Date Received
- November 21, 2012
- Date of Event
- October 25, 2012
- Report Date
- October 25, 2012
- Manufacturer
- RESPIRONICS, INC.
- Product Code
- CBK
- PMA / PMN Number
- K083526
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
DURING THE EVAL OF THE DEVICE AT A THIRD PARTY SVC CENTER, A FAILURE OF THE DEVICE TO POWER ON WAS OBSERVED. THE DEVICE'S POWER SUPPLY PCA AND SYSTEM BOARD WERE REPLACED TO ADDRESS THE ISSUE.
Description of Event or Problem · 1
THE MFR RECEIVED INFO ALLEGING A VENTILATOR WOULD NOT POWER ON. THERE WAS NO HARM ON INJURY REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | TRILOGY 100 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS, INC. | 1054096 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |