FDA Adverse Event Malfunction Summary report: N

PLV-100

MDR report key: 3820085 · Received April 2, 2014

Report

Report Number
2518422-2014-00549
Event Type
Malfunction
Date Received
April 2, 2014
Date of Event
March 5, 2014
Report Date
March 5, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K832467
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR OVERHEATED AND STOPPED WORKING. THERE WAS NO HARM OR INJURY REPORTED. THE DEVICE HAS YET TO BE RETURNED TO THE MANUFACTURER FOR EVALUATION. 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
200270 PLV-100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 35001

Patients

Seq Age Sex Outcome Treatment
1