FDA Adverse Event Malfunction Summary report: N

840 VENTILATOR

MDR report key: 2971141 · Received February 1, 2013

Report

Report Number
8020893-2013-00254
Event Type
Malfunction
Date Received
February 1, 2013
Date of Event
January 8, 2013
Report Date
January 8, 2013
Manufacturer
COVIDIEN, FORMERLY NELLCO
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT AN 840 VENTILATOR WAS INOPERABLE WHILE IN USE OF A PT. THE PT WAS NOT HARMED OR INJURED AS A RESULT OF THE EVENT. COVIDIEN WAS NOT AUTHORIZED TO REPAIR THE UNIT. THE CUSTOMER INSPECTED THE DEVICE AND COULD NOT DUPLICATE THE REPORTED MALFUNCTION. THE CUSTOMER REPORTED TO HAVE CONDUCTED FINAL TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
45360 840 VENTILATOR VENTILATOR CBK COVIDIEN, FORMERLY NELLCO 840

Patients

Seq Age Sex Outcome Treatment
1