FDA Adverse Event Malfunction Summary report: N

840 VENTILATOR

MDR report key: 3921681 · Received May 29, 2014

Report

Report Number
8020893-2014-01299
Event Type
Malfunction
Date Received
May 29, 2014
Report Date
May 1, 2014
Manufacturer
COVIDIEN, FORMERLY NELLCOR PURITAN BENNETT IRELAND
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

COVIDIEN CUSTOMER SUPPORT ENGINEER (CSE) VERIFIED THE MALFUNCTION. THE CSE INSPECTED THE DEVICE AND REPLACED THE GRAPHICAL USER INTERFACE (GUI) CENTRAL PROCESSING UNIT (CPU) PRINTED CIRCUIT BOARD (PCB). THE UNIT PASSED ALL TESTS. (B)(4). A VISUAL INSPECTION OF THE RETURNED PART WAS CONDUCTED AND NO ANOMALIES WERE OBSERVED. THE UNIT WAS ATTACHED TO THE FAILURE INVESTIGATION TEST VENTILATOR FOR ANALYSIS. THE UNIT WAS POWERED UP. THE GUI UPPER DISPLAY WAS DISTORTED, VERIFYING THE REPORTED FAILURE. THE FAULT WAS ISOLATED TO THE VIDEO GRAPHICS ARRAY (VGA) CONTROLLER. NO FURTHER INVESTIGATION OR REPAIR WAS POSSIBLE ON THIS PCB AS NO REPLACEMENT COMPONENT IS AVAILABLE.

Description of Event or Problem · 1

A REPORT RECEIVED FROM THE USA STATED AN 840 VENTILATOR EXPERIENCED A BLANK GRAPHICAL USER INTERFACE (GUI) DISPLAY. THERE WAS NO REPORT OF PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
316256 840 VENTILATOR CBK COVIDIEN, FORMERLY NELLCOR PURITAN BENNETT IRELAND 840

Patients

Seq Age Sex Outcome Treatment
1