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 |