FDA Adverse Event Malfunction Summary report: N

TRILOGY 200

MDR report key: 4113760 · Received September 17, 2014

Report

Report Number
2518422-2014-01596
Event Type
Malfunction
Date Received
September 17, 2014
Date of Event
August 20, 2014
Report Date
August 20, 2014
Manufacturer
RESPIRONICS INC.
Product Code
CBK
PMA / PMN Number
K093416
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DURING THE EVALUATION OF THE DEVICE AT THE MFR'S SERVICE CENTER, A "SERVICE REQUIRED" CODE WAS FOUND IN THE VENTILATOR'S DOWNLOADED ERROR LOG. THE DEVICE'S SENSOR BOARD WAS REPLACED TO ADDRESS THE ISSUE.

Description of Event or Problem · 1

A VENTILATOR WAS RETURNED TO THE MFR FOR ROUTINE PREVENTIVE MAINTENANCE. THERE WAS NO ALLEGATION OF DEVICE MALFUNCTION. THE DEVICE WAS NOT IN PT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
575615 TRILOGY 200 VENTILATOR, CONTINUOUS, FACILITY USE CBK RESPIRONICS INC. 1040005

Patients

Seq Age Sex Outcome Treatment
1