FDA Adverse Event Malfunction Summary report: N

V60 VENTILATOR

MDR report key: 3870813 · Received June 12, 2014

Report

Report Number
2031642-2014-00491
Event Type
Malfunction
Date Received
June 12, 2014
Report Date
May 16, 2014
Manufacturer
RESPIRONICS CALIFORNIA, INC.
Product Code
MNT
PMA / PMN Number
K082660
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

SUPPLEMENTAL REPORT

Additional Manufacturer Narrative · 1

COMPLETION OF DEVICE EVALUATION AND SERVICE PENDING.

Description of Event or Problem · 1

THE INTERNATIONAL CUSTOMER REPORTED THE VENTILATOR WAS ALARMING DUE TO AN OCCLUSION AND THERE WAS NO AIR FLOW. THE VENTILATOR WAS NOT IN USE THEREFORE THERE WAS NO PATIENT INVOLVEMENT OR HARM. COMPLETION OF DEVICE EVALUATION AND SERVICE IS PENDING.

Description of Event or Problem · 1

THE MANUFACTURERS SERVICE ENGINEER WAS UNABLE TO DUPLICATE THE REPORTED PROBLEM. UNIT TESTING PASSED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
347317 V60 VENTILATOR VENTILATOR, CONTINUOUS MNT RESPIRONICS CALIFORNIA, INC. V60 NA

Patients

Seq Age Sex Outcome Treatment
1