BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    840 VENTILATOR

    MDR report key: 3980791 · Received July 24, 2014

    Report

    Report Number
    8020893-2014-01793
    Event Type
    Malfunction
    Date Received
    July 24, 2014
    Date of Event
    January 1, 2014
    Report Date
    July 3, 2014
    Manufacturer
    COVIDIEN
    Product Code
    CBK
    PMA / PMN Number
    K970460
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE CUSTOMER PERFORMED THE REPAIR, AND MULTIPLE UNSUCCESSFUL ATTEMPTS HAVE BEEN MADE TO OBTAIN THE INFORMATION REGARDING THE STATUS OF THE UNIT, IF ANY COMPONENTS WERE REPLACED, AND IF IT WOULD BE RETURNED FOR AN INVESTIGATION.

    Additional Manufacturer Narrative · 1

    THE DEVICE EVAL AND REPAIR WAS NOT YET PERFORMED. (B)(4).

    Description of Event or Problem · 1

    IT WAS REPORTED BY A CUSTOMER IN USA THAT, AN 840 VENTILATOR HAD A BLANK SCREEN. THERE WAS NO PT INVOLVEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    435540 840 VENTILATOR CONTINUOUS VENTILATOR CBK COVIDIEN 840

    Patients

    Seq Age Sex Outcome Treatment
    1