FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3902503 · Received May 7, 2014

Report

Report Number
2518422-2014-00739
Event Type
Malfunction
Date Received
May 7, 2014
Date of Event
April 10, 2014
Report Date
April 10, 2014
Manufacturer
RESPIRONICS, INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
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 SENSOR BOARD WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING AN ISSUE WITH A VENTILATOR'S TIDAL VOLUME. THE DEVICE WAS NOT IN PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
276916 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS, INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1