FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3880812 · Received April 9, 2014

Report

Report Number
2518422-2014-00597
Event Type
Malfunction
Date Received
April 9, 2014
Date of Event
March 12, 2014
Report Date
March 12, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE MANUFACTURER FOR EVALUATION AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE DEVICE'S POWER SUPPLY AND SYSTEM BOARD WERE PLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFO FROM A THIRD PARTY SERVICE CENTER ALLEGING A VENTILATOR WOULD NOT POWER ON. THERE WAS NO HARM OR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
214075 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054096

Patients

Seq Age Sex Outcome Treatment
1