FDA Adverse Event Malfunction Summary report: N

840 VENTILATOR

MDR report key: 3962644 · Received June 18, 2014

Report

Report Number
8020893-2014-01450
Event Type
Malfunction
Date Received
June 18, 2014
Date of Event
May 20, 2014
Report Date
May 22, 2014
Manufacturer
COVIDIEN, FORMERLY NELLCOR PURITAN
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE COVIDIEN CUSTOMER SUPPORT ENGINEER (CSE) EVALUATED THE UNIT, AND VERIFIED THE REPORTED MALFUNCTION. THE CSE REPLACED THE GRAPHIC USER INTERFACE (GUI), PRINTED CIRCUIT BOARD (PCB), THE BACKLIGHT INVERTER, PRINTED CIRCUIT BOARD (PCB), AND UPGRADED THE SOFTWARE TO THE CURRENT REVISION. THE UNIT PASSED ALL TESTS AND CALIBRATIONS, AND IT WAS OBSERVED TO BE OPERATING WITHIN MANUFACTURING SPECIFICATIONS. COVIDIEN REFERENCE # (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED A CUSTOMER IN THE USA THAT AN 840 VENTILATOR GRAPHIC USER INTERFACE (GUI) DISPLAY WAS INOPERABLE. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
356901 840 VENTILATOR CBK COVIDIEN, FORMERLY NELLCOR PURITAN 840

Patients

Seq Age Sex Outcome Treatment
1