FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 4092809
·
Received August 20, 2014
Report
- Report Number
- 2518422-2014-01406
- Event Type
- Malfunction
- Date Received
- August 20, 2014
- Date of Event
- July 23, 2014
- Report Date
- July 23, 2014
- Manufacturer
- RESPIRONICS INC.
- Product Code
- CBK
- PMA / PMN Number
- K083526
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
DURING EVALUATION OF THE DEVICE AT THE MANUFACTURER'S SERVICE CENTER, "VENTILATOR INOPERATIVE" CODES WERE OBSERVED IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE'S SOFTWARE WAS RELOADED TO ADDRESS THE ISSUE. THE REPAIR OF THE DEVICE IS STILL IN PROGRESS, PENDING CUSTOMER APPROVAL OF THE ESTIMATE.
Description of Event or Problem · 1
A VENTILATOR WAS RETURNED TO THE MANUFACTURER FOR ROUTINE PREVENTIVE MAINTENANCE. THERE WAS NO ALLEGATION OF DEVICE MALFUNCTION. THE DEVICE WAS NOT IN PATIENT USE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 500683 | TRILOGY 100 | VENTILATOR, CONINUOUS, FACILITY USE | CBK | RESPIRONICS INC. | 1054260 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |