FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 3980244 · Received July 2, 2014

Report

Report Number
2518422-2014-01111
Event Type
Malfunction
Date Received
July 2, 2014
Date of Event
June 4, 2014
Report Date
June 4, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
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.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR WOULD NOT POWER ON. THE DEVICE WAS NOT IN PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
387032 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054096

Patients

Seq Age Sex Outcome Treatment
1