FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3880589 · Received April 9, 2014

Report

Report Number
2518422-2014-00593
Event Type
Malfunction
Date Received
April 9, 2014
Date of Event
March 18, 2014
Report Date
March 18, 2014
Manufacturer
RESPIRONICS, INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE MANUFACTURER FOR EVALUATION AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE DEVICE'S SENSOR BOARD WAS REPLACED TO ADDRESS THE ISSUES.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A "SERVICE REQUIRED" ALARM CONDITION OCCURRED. THE DEVICE WAS NOT IN PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
213347 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS, INC. 1054096

Patients

Seq Age Sex Outcome Treatment
1