FDA Adverse Event Malfunction Summary report: N

V60 VENTILATOR

MDR report key: 4932572 · Received July 22, 2015

Report

Report Number
2031642-2015-01368
Event Type
Malfunction
Date Received
July 22, 2015
Report Date
June 24, 2015
Manufacturer
RESPIRONICS CALIFORNIA, INC
Product Code
MNT
PMA / PMN Number
K082660
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Additional Manufacturer Narrative · 1

EVENT DATE: (B)(6) 2015. CONCLUSION / ROOT CAUSE: THIS IS THE OLD STYLE DATA ACQUISITION TO MOTOR CONTROLLER CABLE. NO FURTHER FI IS REQUIRED. PLEASE REFERENCE CAPA (B)(4). THIS REPORT IS BEING SUBMITTED AS PART OF THE REMEDIATION FOR CAPA (B)(4).

Description of Event or Problem · 1

THE INTERNATIONAL MANUFACTURER'S SERVICE ENGINEER REPORTED FINDING CODES IN THE DIAGNOSTIC REPORT OF THE DEVICE INDICATING A SPI BUS FAILURE, WHICH IS WHEN THE PCBA ADC REFERENCE FAILS. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 1

THE INTERNATIONAL MANUFACTURER'S SERVICE ENGINEER REPORTED FINDING CODES IN THE DIAGNOSTIC REPORT OF THE DEVICE INDICATING A SPI BUS FAILURE, WHICH IS WHEN THE PCBA ADC REFERENCE FAILS. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
477278 V60 VENTILATOR VENTILATOR, CONTINUOUS, MINIMAL VENTILATORY SUPPORT,FACILITY USE MNT RESPIRONICS CALIFORNIA, INC V60

Patients

Seq Age Sex Outcome Treatment
1