FDA Adverse Event Injury Summary report: N

HT70 VENTILATOR

MDR report key: 3001620 · Received March 11, 2013

Report

Report Number
2023050-2013-00166
Event Type
Injury
Date Received
March 11, 2013
Date of Event
December 4, 2013
Report Date
February 18, 2013
Manufacturer
NEWPORT MEDICAL INSTRUMENTS
Product Code
CBK
PMA / PMN Number
K090888
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THOUGH REQUESTED, ADDITIONAL PATIENT INFORMATION WAS NOT PROVIDED.

Description of Event or Problem · 1

REPORTEDLY, DURING PATIENT USE, THE SILENCE LED FLASHED SIMULTANEOUSLY BUT THERE WAS NO ALARM. THE UNIT SHUT DOWN WITHOUT ANY ALARM AND THE PATIENT WAS AMBU BAGGED BEFORE BEING SWITCHED TO ANOTHER VENTILATOR. THERE WERE NO ADVERSE PATIENT EFFECTS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
101649 HT70 VENTILATOR CBK, NOU CBK NEWPORT MEDICAL INSTRUMENTS HT70

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention