FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 3982878
·
Received July 2, 2014
Report
- Report Number
- 2518422-2014-01080
- Event Type
- Malfunction
- Date Received
- July 2, 2014
- Date of Event
- June 5, 2014
- Report Date
- June 5, 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, A "SERVICE REQUIRED" CODE RELATED TO THE INTERNAL BATTERY WAS FOUND IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE WAS RETURNED UNREPAIRED TO THE CUSTOMER, PER 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 |
|---|---|---|---|---|---|---|---|
| 387458 | TRILOGY 100 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS INC. | 1054096 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |