FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3030666 · Received March 27, 2013

Report

Report Number
2518422-2013-00494
Event Type
Malfunction
Date Received
March 27, 2013
Date of Event
March 4, 2013
Report Date
March 4, 2013
Manufacturer
RESPIRONICS INC
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE MFR FOR EVAL AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE VENTILATOR'S EXHAUST FAN ASSEMBLY WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MFR RECEIVED INFO ALLEGING A HIGH TEMP ALARM OCCURRED. THERE WAS NO HARM OR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
125312 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC 1054096

Patients

Seq Age Sex Outcome Treatment
1