FDA Adverse Event Malfunction Summary report: N

HT70 VENTILATOR

MDR report key: 3050249 · Received April 5, 2013

Report

Report Number
2023050-2013-00277
Event Type
Malfunction
Date Received
April 5, 2013
Date of Event
September 10, 2012
Report Date
April 5, 2013
Manufacturer
NEWPORT MEDICAL INSTRUMENTS, INC.
Product Code
CBK
PMA / PMN Number
K090888
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE RETURNED OXYGEN SENSOR WAS VISUALLY INSPECTED AND NO ANOMALIES WERE FOUND. DURING THE FUNCTIONAL TEST, THE FIO2 SUPPLY MEASURED WAS DIFFERENT FROM THE FIO2 SETTING. THE INVESTIGATION CONCLUDED THAT THE OXYGEN SENSOR WAS DEFECTIVE. THE UNIT WILL BE RETURNED AFTER REPLACING THE OXYGEN SENSOR.

Description of Event or Problem · 1

DURING INVESTIGATING THE RETURNED VENTILATOR WITH THE REPORTED ISSUE WITH FAILED OXYGEN ANALYZER, IT WAS NEWLY FOUND THAT THE OXYGEN SENSOR WAS FAULTY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
139832 HT70 VENTILATOR CBK, NOU CBK NEWPORT MEDICAL INSTRUMENTS, INC. HT70

Patients

Seq Age Sex Outcome Treatment
1