FDA Adverse Event Malfunction Summary report: N

LTV

MDR report key: 3060640 · Received March 28, 2013

Report

Report Number
2031702-2013-00056
Event Type
Malfunction
Date Received
March 28, 2013
Report Date
March 27, 2013
Manufacturer
CAREFUSION 203, INC
Product Code
CBK
PMA / PMN Number
K060647
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NO INFORMATION

Narratives

Additional Manufacturer Narrative · 1

NA.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR INTERMITTENTLY TURNS ON AND OFF BUT WAS NOT CONNECTED TO A PT. IT IS UNK IF THE VENTILATOR HAD AN AUDIBLE ALARM WHEN THE REPORTED PROBLEM OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
127263 LTV VENTILATOR, CONTINUOUS / CBK CBK CAREFUSION 203, INC LTV 1200 NA

Patients

Seq Age Sex Outcome Treatment
1 NA