BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    840 VENTILATOR

    MDR report key: 2903825 · Received January 4, 2013

    Report

    Report Number
    8020893-2013-00035
    Event Type
    Malfunction
    Date Received
    January 4, 2013
    Date of Event
    December 21, 2012
    Report Date
    December 21, 2012
    Manufacturer
    COVIDIEN, FORMERLY NELLCOR PURITAN
    Product Code
    CBK
    PMA / PMN Number
    K970460
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    COVIDIEN RECEIVED INFO THAT AN 840 VENTILATOR STOPPED CYCLING. THERE WAS NO PT INVOLVEMENT. THE CUSTOMER REPORTED TO HAVE PASSED EXTENDED SELF TEST. COVIDIEN TECHNICAL SUPPORT ENGINEER (TSE) ADVISED THE CUSTOMER TO RUN THE VENTILATOR ON A TEST LUNG. COVIDIEN WAS NOT AUTHORISED TO SVC THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    5149 840 VENTILATOR VENTILATOR CBK COVIDIEN, FORMERLY NELLCOR PURITAN 840

    Patients

    Seq Age Sex Outcome Treatment
    1