FDA Adverse Event Malfunction Summary report: N

LTV

MDR report key: 3132359 · Received May 1, 2013

Report

Report Number
2031702-2013-00098
Event Type
Malfunction
Date Received
May 1, 2013
Report Date
May 1, 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
NJ, US
Reporter Occupation
SERVICE AND TESTING PERSONNEL

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR RESET AND WOULD NOT POWER BACK UP. IT IS UNK IF THE VENTILATOR ALARMED OR IF IT WAS CONNECTED TO A PT WHEN THE REPORTED PROBLEM OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
190919 LTV VENTILATOR, CONTINUOUS / CBK CBK CAREFUSION 203, INC LTV 1200 NA

Patients

Seq Age Sex Outcome Treatment
1 NI