BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    840 VENTILATOR

    MDR report key: 3900419 · Received May 6, 2014

    Report

    Report Number
    8020893-2014-01081
    Event Type
    Malfunction
    Date Received
    May 6, 2014
    Report Date
    April 8, 2014
    Manufacturer
    COVIDIEN, FORMERLY NELLCOR PURITAN BENNETT IRELAND
    Product Code
    CBK
    PMA / PMN Number
    K970460
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    NO INFORMATION

    Narratives

    Additional Manufacturer Narrative · 1

    COVIDIEN TECHNICAL SUPPORT ENGINEER (TSE) TROUBLESHOT THE ISSUE WITH THE CUSTOMER OVER THE PHONE. THE TSE SUGGESTED REPLACING THE GUI CENTRAL PROCESSING UNIT (CPU) AND THE BACKLIGHT INVERTER PRINTED CIRCUIT BOARD (PCB). COVIDIEN WAS NOT AUTHORIZED TO SERVICE DEVICE. COVIDIEN REF: (B)(4).

    Description of Event or Problem · 1

    A REPORT WAS RECEIVED FROM THE USA WITH INFO STATING THAT AN 840 VENTILATOR HAD ERRATIC GRAPHICAL USER INTERFACE (GUI) DISPLAY. THE DEVICE WAS NOT BEING USED ON A PT WHEN EVENT OCCURRED. THE DATE OF THE EVENT WAS NOT REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271968 840 VENTILATOR CBK COVIDIEN, FORMERLY NELLCOR PURITAN BENNETT IRELAND 840

    Patients

    Seq Age Sex Outcome Treatment
    1