FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3913083 · Received May 14, 2014

Report

Report Number
2518422-2014-00780
Event Type
Malfunction
Date Received
May 14, 2014
Date of Event
April 17, 2014
Report Date
April 17, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
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 SYSTEM BOARD WAS REPLACED TO ADDRESS THE ISSUE. DURING THE EVALUATION OF THE DEVICE AT THE MANUFACTURER'S SERVICE CENTER, SERVICE REQUIRED CODES WERE FOUND IN THE VENTILATOR¿S DOWNLOADED ERROR LOG. THE DEVICE'S SENSOR BOARD AND INTERNAL BATTERY WERE REPLACED TO ADDRESS THE ISSUES.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION 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
288298 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054096

Patients

Seq Age Sex Outcome Treatment
1