FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 2941121 · Received January 16, 2013

Report

Report Number
2518422-2013-00082
Event Type
Malfunction
Date Received
January 16, 2013
Date of Event
January 4, 2013
Report Date
January 4, 2013
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DURING THE EVAL OF THE DEVICE AT THE MFR'S SERVICE CENTER, "SERVICE REQUIRED" CODES WERE FOUND IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE'S SYSTEM BOARD AND POWER MANAGEMENT BOARD WERE REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

A VENTILATOR WAS RETURNED TO THE MFR FOR SERVICE. THE DEVICE WAS NOT IN PT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
25168 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1