FDA Adverse Event Malfunction Summary report: N

ESPRIT VENTILATOR

MDR report key: 2920817 · Received January 17, 2013

Report

Report Number
2031642-2013-00024
Event Type
Malfunction
Date Received
January 17, 2013
Report Date
January 8, 2013
Manufacturer
RESPIRONICS CALIFORNIA, INC.
Product Code
CBK
PMA / PMN Number
K981072
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THE VENTILATOR ALARMED AND RESTARTED WHILE IN USE ON A PATIENT. THE CUSTOMER REPORTED THERE WAS NO PATIENT HARM. THE MANUFACTURER'S SERVICE TECHNICIAN WAS UNABLE TO DUPLICATE THE CUSTOMER REPORTED PROBLEM. THE SERVICE TECHNICIAN VERIFIED A DIAGNOSTIC CODE IN THE VENTILATOR LOG HISTORY THAT INDICATED A VENTILATOR RESTART. PERFORMANCE VERIFICATION TESTING WAS COMPLETED AND TESTS PASSED PER OPERATING SPECIFICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
26375 ESPRIT VENTILATOR VENTILATOR, CONTINUOUS CBK RESPIRONICS CALIFORNIA, INC. V1000 NA

Patients

Seq Age Sex Outcome Treatment
1