FDA Adverse Event Malfunction Summary report: N

CAREFUSION

MDR report key: 4808075 · Received May 29, 2015

Report

Report Number
2021710-2015-01061
Event Type
Malfunction
Date Received
May 29, 2015
Date of Event
April 28, 2015
Report Date
April 28, 2015
Manufacturer
CAREFUSION
Product Code
CBK
PMA / PMN Number
K073069
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

A CAREFUSION FIELD SERVICE REPRESENTATIVE WAS DISPATCHED TO THE USER FACILITY. THE FIELD SERVICE REPRESENTATIVE EVALUATED THE DEVICE AND WAS UNABLE TO REPRODUCE/VERIFY THE REPORTED EVENT. THE CAREFUSION FIELD SERVICE REPRESENTATIVE RAN THE DEVICE THROUGH THE OPERATIONAL VERIFICATION PROCEDURE (OVP) AND THE DEVICE PASSED ALL TESTS.

Additional Manufacturer Narrative · 1

(B)(4). CAREFUSION HAS DISPATCHED A CAREFUSION FIELD SERVICE REPRESENTATIVE TO EVALUATE AND REPAIR THE DEVICE. THE CAREFUSION FIELD SERVICE REPRESENTATIVE HAS NOT COMPLETED THE EVALUATION OF THE DEVICE AS MAY 27, 2015. CAREFUSION WILL SUBMIT A FOLLOW-UP MEDWATCH REPORT ONCE THE EVALUATION AND REPAIR HAVE BEEN COMPLETED.

Description of Event or Problem · 1

THE USER FACILITY BIOMED REPORTED THAT WHEN DOING THE COMPRESSOR TEST AND THE DEVICE IS SWITCHED FROM WALL AIR TO COMPRESSOR THEY GET COMPRESSOR OUTPUT LOW ERROR ("LOSS, AIR" MESSAGE) ON THE SCREEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
350378 CAREFUSION VENTILATOR, CONTINUOUS, FACILITY USE/CBK CBK CAREFUSION AVEA NA

Patients

Seq Age Sex Outcome Treatment
1 NA