FDA Adverse Event Malfunction Summary report: N

LTV

MDR report key: 2862775 · Received November 1, 2012

Report

Report Number
2031702-2012-00280
Event Type
Malfunction
Date Received
November 1, 2012
Report Date
November 1, 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
CA, US
Reporter Occupation
NO INFORMATION

Narratives

Additional Manufacturer Narrative · 1

NA

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR WAS CONSTANTLY RESETTING WITH AN AUDIBLE ALARM. THE VENTILATOR WAS NOT 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 NA