FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 100
MDR report key: 4102399
·
Received August 27, 2014
Report
- Report Number
- 2518422-2014-01448
- Event Type
- Malfunction
- Date Received
- August 27, 2014
- Date of Event
- August 5, 2014
- Report Date
- August 5, 2014
- Manufacturer
- RESPIRONICS INC.
- Product Code
- CBK
- PMA / PMN Number
- K083526
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
DURING THE EVAL OF THE DEVICE AT THE THIRD PARTY SERVICE CTR, AN ISSUE RELATED TO THE BLOWER MOTOR WAS OBSERVED. THE DEVICE'S BLOWER MOTOR WAS REPLACED TO ADDRESS THE ISSUE.
Description of Event or Problem · 1
A VENTILATOR WAS RETURNED TO A THIRD PARTY SERVICE CTR FOR EVAL. THE DEVICE WAS NOT IN PT USE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 519104 | TRILOGY 100 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS INC. | 1054260 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |