FDA Adverse Event Death Summary report: N

LTV

MDR report key: 4157481 · Received October 9, 2014

Report

Report Number
2031702-2014-00221
Event Type
Death
Date Received
October 9, 2014
Date of Event
September 7, 2014
Report Date
August 17, 2015
Manufacturer
CAREFUSION 203, INC
Product Code
CBK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
RESPIRATORY THERAPIST
Health Professional
N

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTILATOR HAD AN AUDIBLE DISC/SENSE ALARM. THE PATIENT WAS REMOVED FROM THE VENTILATOR, MANUALLY VENTILATED, AND TAKEN TO THE HOSPITAL. THE PATIENT HAD A HEART ATTACK WHILE CONNECTED TO THE VENTILATOR AND WAS PRONOUNCED DEAD AT THE HOSPITAL. THE RESPIRATORY THERAPIST (RT) HAD CHECKED THREE PATIENT CIRCUITS AND THEY HAD FAILED THE LEAK TEST. THE RT CONNECTED A KNOWN GOOD PATIENT CIRCUIT AND THE VENTILATOR PASSED THE LEAK TEST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
635227 LTV VENTILATOR, CONTINUOUS CBK CAREFUSION 203, INC LTV 950

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Death