FDA Adverse Event Malfunction Summary report: N

LTV

MDR report key: 3032153 · Received March 6, 2013

Report

Report Number
2031702-2013-00043
Event Type
Malfunction
Date Received
March 6, 2013
Report Date
March 6, 2013
Manufacturer
CAREFUSION 203, INC.
Product Code
CBK
PMA / PMN Number
NA
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
NO INFORMATION

Narratives

Additional Manufacturer Narrative · 1

NA

Description of Event or Problem · 1

IT WAS REPORTED THAT THE NURSE CALL ALAR PORT IS NOT ACTIVATING WHEN THE VENTILATOR ALARMS. IT IS UNK IF THE VENTILATOR WAS CONNECTED TO A PT WHEN THE REPORTED PROBLEM OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
96633 LTV VENTILATOR, CONTINUOUS/CBK CBK CAREFUSION 203, INC. LTV 1150 NA

Patients

Seq Age Sex Outcome Treatment
1 NI