FDA Adverse Event Malfunction Summary report: N

TRILOGY 200

MDR report key: 3902492 · Received May 7, 2014

Report

Report Number
2518422-2014-00755
Event Type
Malfunction
Date Received
May 7, 2014
Date of Event
April 13, 2014
Report Date
April 13, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K093416
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER REC'D INFO ALLEGING THE EXPIRATION VALVE IN THE PATIENT CIRCUIT WOULD NOT CLOSE. THE DEVICE WAS NOT IN PATIENT USE. THE DEVICE HAS NOT YET BEEN EVALUATED BY THE MANUFACTURER. AT THIS TIME, WE ARE UNABLE TO CONFIRM THE ALLEGED MALFUNCTION. A F/U REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
276912 TRILOGY 200 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1032804

Patients

Seq Age Sex Outcome Treatment
1