FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3102279 · Received April 30, 2013

Report

Report Number
2518422-2013-00654
Event Type
Malfunction
Date Received
April 30, 2013
Date of Event
April 2, 2013
Report Date
April 2, 2013
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR'S KEYPAD WAS NOT FUNCTIONING. THE DEVICE WAS NOT IN PATIENT USE. THE DEVICE HAS NOT YET BEEN EVALUATED BY THE MANUFACTURER. AT THIS TIME, WE ARE UNABLE TO CONFIRM THE ALLEGED MALFUNCTION. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
188106 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054097

Patients

Seq Age Sex Outcome Treatment
1