FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 2913399 · Received January 9, 2013

Report

Report Number
2518422-2013-00039
Event Type
Malfunction
Date Received
January 9, 2013
Date of Event
December 14, 2012
Report Date
December 14, 2012
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE MFR FOR EVALUATION AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE DEVICE'S LCD DISPLAY SCREEN WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MFR RECEIVED INFORMATION ALLEGING A VENTILATOR'S DISPLAY SCREEN WAS DISTORTED. THERE WAS NO HARM OR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
13305 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1