FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 202
MDR report key: 3963274
·
Received June 19, 2014
Report
- Report Number
- 2518422-2014-00978
- Event Type
- Malfunction
- Date Received
- June 19, 2014
- Date of Event
- May 23, 2014
- Report Date
- May 23, 2014
- Manufacturer
- RESPIRONICS INC
- Product Code
- CBK
- PMA / PMN Number
- K093905
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
DURING THE EVAL OF THE DEVICE AT THE MFR'S SERVICE CTR, A "SERVICE REQUIRED" CODE WAS FOUND IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE'S OXYGEN BLENDING MODULE BOARD WAS REPLACED TO ADDRESS THE ISSUE.
Description of Event or Problem · 1
THE MFR RECEIVED INFO ALLEGING A VENTILATOR WAS ALARMING. THERE WAS NO HARM OR INJURY REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 359630 | TRILOGY 202 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS INC | 1040007 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |