FDA Adverse Event
Malfunction
Summary report: N
LTV
MDR report key: 3171857
·
Received May 23, 2013
Report
- Report Number
- 2031702-2013-00114
- Event Type
- Malfunction
- Date Received
- May 23, 2013
- Date of Event
- April 11, 2013
- Report Date
- May 23, 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
- NY, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
NA
Description of Event or Problem · 1
IT WAS REPORTED THAT THE VENTILATOR APPEARED TO HAVE SHUT DOWN WITH NO AUDIBLE ALARM WHILE CONNECTED TO A PT. NO PT HARM REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 228952 | LTV | VENTILATOR, CONTINUOUS/CBK | CBK | CAREFUSION 203, INC. | LTV 1200 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NI |