FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3905202 · Received May 28, 2014

Report

Report Number
2518422-2014-00868
Event Type
Malfunction
Date Received
May 28, 2014
Date of Event
May 6, 2014
Report Date
May 6, 2014
Manufacturer
RESPIRONICS, INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DURING THE EVALUATION OF THE DEVICE AT THE MANUFACTURER'S SERVICE CENTER, A "SERVICE REQUIRED" CODE WAS FOUND IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE'S SENSOR BOARD WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

A VENTILATOR WAS RETURNED TO THE MANUFACTURER FOR ROUTINE PREVENTIVE MAINTENANCE. THERE WAS NO ALLEGATION OF DEVICE MALFUNCTION. THE DEVICE WAS NOT IN PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
314837 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS, INC. 1054655

Patients

Seq Age Sex Outcome Treatment
1