FDA Adverse Event Injury Summary report: N

HT70 VENTILATOR

MDR report key: 3032447 · Received March 29, 2013

Report

Report Number
2023050-2013-00254
Event Type
Injury
Date Received
March 29, 2013
Date of Event
February 28, 2013
Report Date
March 11, 2013
Manufacturer
NEWPORT MEDICAL INSTRUMENTS, INC.
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

ALTHOUGH REQUESTED, ADDITIONAL PATIENT INFO WAS NOT PROVIDED.

Description of Event or Problem · 1

DURING PT USE, SUDDENLY A "SWITCHED TO BACKUP BATTERY" OCCURRED WHEN THE AC CABLE WAS REMOVED. AFTER THAT, THE POWER PAC INDICATOR SHOWED 1%. THE PT WAS AMBU BAGGED AND SWITCHED TO ANOTHER VENTILATOR. NO PERMANENT INJURY WAS REPORTED IN THIS CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
130168 HT70 VENTILATOR CBK, NOU CBK NEWPORT MEDICAL INSTRUMENTS, INC. HT70

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention