FDA Adverse Event
Malfunction
Summary report: N
TRILOGY 202
MDR report key: 4253290
·
Received November 12, 2014
Report
- Report Number
- 2518422-2014-02031
- Event Type
- Malfunction
- Date Received
- November 12, 2014
- Date of Event
- October 20, 2014
- Report Date
- October 20, 2014
- Manufacturer
- RESPIRONICS INC
- Product Code
- CBK
- PMA / PMN Number
- K093905
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IN
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Description of Event or Problem · 1
THE MFR RECEIVED INFO ALLEGING A VENTILATOR WAS NOT POWERING ON. THERE WAS NO HARM OR INJURY REPORTED. THE DEVICE HAS YET TO BE RETURNED TO THE MFR FOR EVAL. AT THIS TIME, WE ARE UNABLE TO CONFIRM THE ALLEGED MALFUNCTION. A FOLLOW UP REPORT WILL BE SUBMITTED WHEN THE MFR'S INVESTIGATION IS COMPLETE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 729474 | TRILOGY 202 | VENTILATOR, CONTINUOUS, FACILITY USE | CBK | RESPIRONICS INC | 1040000 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |