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 |