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 |