FDA Adverse Event Malfunction Summary report: N

840 VENTILATOR

MDR report key: 4101869 · Received August 25, 2014

Report

Report Number
8020893-2014-02110
Event Type
Malfunction
Date Received
August 25, 2014
Date of Event
August 8, 2014
Report Date
August 14, 2014
Manufacturer
COVIDIEN
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE COVIDIEN CUSTOMER SUPPORT ENGINEER (CSE) VERIFIED THE MALFUNCTION AND REPLACED THE GRAPHICAL USER INTERFACE (GUI) PRINTED CIRCUIT BOARD (PCB), AND UPGRADED THE SOFTWARE TO THE CURRENT REVISION. THE UNIT PASSED ALL TESTING, AND OPERATES WITHIN THE MANUFACTURING SPECIFICATIONS. (B)(4).

Description of Event or Problem · 1

COVIDIEN RECEIVED INFO STATING THAT AN 840 VENTILATOR HAD AN INOPERABLE GRAPHICAL USER INTERFACE (GUI) DISPLAY. THE VENTILATOR WAS NOT IN USE ON A PT AT THE TIME THE MALFUNCTION OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
511339 840 VENTILATOR CONTINUOUS VENTILATOR CBK COVIDIEN 840

Patients

Seq Age Sex Outcome Treatment
1