FDA Adverse Event
Malfunction
Summary report: N
LTV
MDR report key: 2860040
·
Received October 31, 2012
Report
- Report Number
- 2031702-2012-00276
- Event Type
- Malfunction
- Date Received
- October 31, 2012
- Report Date
- October 31, 2012
- Manufacturer
- CAREFUSION 203, INC
- Product Code
- CBK
- PMA / PMN Number
- K060647
- Removal / Correction Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- NO INFORMATION
Narratives
Additional Manufacturer Narrative · 1
NA.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE VENTILATOR'S TURBINE DID NOT ROTATE. IT IS UNK IF THE VENTILATOR ALARMED OR IF IT WAS CONNECTED TO A PT WHEN THE REPORTED PROBLEM OCCURRED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LTV | VENTILATOR, CONTINUOUS / CBK | CBK | CAREFUSION 203, INC | LTV 1200 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NI |