FDA Adverse Event Malfunction Summary report: N

TRILOGY 02

MDR report key: 3813197 · Received March 26, 2014

Report

Report Number
2518422-2014-00507
Event Type
Malfunction
Date Received
March 26, 2014
Date of Event
March 3, 2014
Report Date
March 3, 2014
Manufacturer
RESPIRONICS, INC.
Product Code
CBK
PMA / PMN Number
K093905
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR WOULD NOT DELIVER THE SET PRESSURE. THE DEVICE WAS NOT IN PATIENT USE. THE DEVICE HAS NOT YET BEEN EVALUATED BY THE MANUFACTURER. AT THIS TIME, WE ARE UNABLE TO CONFIRM THE ALLEGED MALFUNCTION. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
176893 TRILOGY 02 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS, INC. 1040004

Patients

Seq Age Sex Outcome Treatment
1