FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 3201473
·
Received June 26, 2013
Report
- Report Number
- 2518422-2013-01304
- Event Type
- Malfunction
- Date Received
- June 26, 2013
- Date of Event
- June 1, 2013
- Report Date
- June 1, 2013
- Manufacturer
- RESPIRONICS INC.
- Product Code
- CBK
- PMA / PMN Number
- K083526
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
DURING THE EVAL OF THE DEVICE AT THE MFR'S SERVICE CENTER, AN ISSUE RELATED TO THE LCD DISPLAY SCREEN WAS OBSERVED. THE VENTILATOR'S LCD DISPLAY SCREEN WAS REPLACED TO ADDRESS THE ISSUE.
Description of Event or Problem · 1
A VENTILATOR WAS RETURNED TO THE MFR FOR ROUTINE PREVENTIVE MAINTENANCE. THE DEVICE WAS NOT IN PT USE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 290545 | TRILOGY 100 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS INC. | 1054260 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |