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