FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 3982822
·
Received July 2, 2014
Report
- Report Number
- 2518422-2014-01076
- 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
- FR
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
DURING THE EVALUATION OF THE DEVICE AT THE MANUFACTURER'S SERVICE CENTER, "SERVICE REQUIRED" CODES WERE OBSERVED IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE OBSERVED CODES WERE RELATED TO THE INTERNAL BATTERY AND THE POWER MANAGEMENT BOARD. THE CUSTOMER REJECTED THE REPAIR ESTIMATE, SO THE DEVICE WAS SCRAPPED AT THE CUSTOMER'S REQUEST.
Description of Event or Problem · 1
A VENTILATOR WAS RETURNED TO THE MANUFACTURER FOR SERVICE. THERE WAS NO HARM OR INJURY REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 387556 | TRILOGY 100 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS, INC. | 1054096 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |