FDA Adverse Event Malfunction Summary report: N

TRILOGY 100

MDR report key: 4102432 · Received August 27, 2014

Report

Report Number
2518422-2014-01455
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
GA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE VENTILATOR WAS RETURNED TO THE THIRD PARTY SERVICE CENTER FOR EVALUATION AND THE CUSTOMER'S COMPLAINT WAS CONFIRMED. THE DEVICE'S SYSTEM BOARD WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

THE MANUFACTURER RECEIVED INFORMATION FROM A THIRD PARTY SERVICE CENTER ALLEGING A VENTILATOR WOULD NOT POWER ON. THE DEVICE WAS NOT IN PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
518989 TRILOGY 100 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS, INC. 1054260

Patients

Seq Age Sex Outcome Treatment
1