FDA Adverse Event Malfunction Summary report: N

SERVO-I

MDR report key: 3770422 · Received February 18, 2014

Report

Report Number
8010042-2014-00036
Event Type
Malfunction
Date Received
February 18, 2014
Date of Event
January 29, 2014
Report Date
January 30, 2014
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K062793
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A SERVICE ENGINEER HAS BEEN ON SITE AND STARTED THE INVESTIGATION. A SUPPLEMENTAL MDR REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR GENERATED ALARMS FOR LOW OXYGEN CONCENTRATION. THERE WAS NO HARM TO PT. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
103617 SERVO-I CBK MAQUET CRITICAL CARE AB NA NA

Patients

Seq Age Sex Outcome Treatment
1 NI