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