FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 4102369 · Received August 27, 2014

Report

Report Number
2518422-2014-01503
Event Type
Malfunction
Date Received
August 27, 2014
Date of Event
August 1, 2014
Report Date
August 1, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K083526
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION ALLEGING A VENTILATOR WAS AUTO CYCLING. THERE WAS NO HARM OR INJURY REPORTED. THE DEVICE HAS NOT YET BEEN EVALUATED BY THE MANUFACTURER. 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
522635 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1