FDA Adverse Event Malfunction Summary report: N

TRILOGY 200

MDR report key: 3140010 · Received May 28, 2013

Report

Report Number
2518422-2013-00964
Event Type
Malfunction
Date Received
May 28, 2013
Date of Event
May 7, 2013
Report Date
May 7, 2013
Manufacturer
RESPIRONICS INC
Product Code
CBK
PMA / PMN Number
K093416
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE MFR FOR EVAL AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE DEVICE'S SYSTEM BOARD WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MFR RECEIVED INFO ALLEGING A "SERVICE REQUIRED" ALARM CONDITION OCCURRED. THERE WAS NO HARM OR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
233023 TRILOGY 200 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC 1032804

Patients

Seq Age Sex Outcome Treatment
1