FDA Adverse Event Summary report: N

840 VENTILATOR

MDR report key: 4102975 · Received September 19, 2014

Report

Report Number
8020893-2014-02165
Date Received
September 19, 2014
Date of Event
January 1, 2014
Report Date
August 15, 2014
Manufacturer
COVIDIEN
Product Code
CBK
PMA / PMN Number
K970460
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, 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.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

COVIDIEN RECEIVED INFO STATING THAT AN 840 VENTILATOR EXPERIENCED AN ERRATIC LOWER 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
583892 840 VENTILATOR CONTINUOUS VENTILATOR CBK COVIDIEN 840

Patients

Seq Age Sex Outcome Treatment
1