FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 4012755 · Received July 10, 2014

Report

Report Number
2518422-2014-01184
Event Type
Malfunction
Date Received
July 10, 2014
Date of Event
June 12, 2014
Report Date
June 12, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFO ALLEGING A VENTILATOR WAS NOT DELIVERING ADEQUATE VOLUME. THE DEVICE WAS NOT IN PT USE. THE DEVICE HAS YET TO BE RETURNED TO THE MANUFACTURER FOR EVAL. AT THIS TIME, WE ARE UNABLE TO CONFIRM THE ALLEGED MALFUNCTION. A FOLLOW UP REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
405509 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1