FDA Adverse Event
Injury
Summary report: N
HT70 PLUS VENTILATOR
MDR report key: 6177616
·
Received December 15, 2016
Report
- Report Number
- 2023050-2016-00742
- Event Type
- Injury
- Date Received
- December 15, 2016
- Report Date
- November 16, 2016
- Manufacturer
- NEWPORT MEDICAL INSTRUMENTS, INC
- Product Code
- CBK
- PMA / PMN Number
- K111146
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4).
Additional Manufacturer Narrative · 1
(B)(4). THE VENTILATOR WAS RETURNED FOR EVALUATION. THE ALLEGED MALFUNCTION COULD NOT BE CONFIRMED. NO FAULT WAS FOUND WITH THE DEVICE.
Description of Event or Problem · 1
IT WAS REPORTED THAT, WHILE IN USE ON A PATIENT, A HT70 PLUS VENTILATOR'S FLOW WAS NOT WORKING. THE PATIENT WAS REMOVED FROM THE VENTILATOR AND PLACED ON AN ALTERNATE VENTILATOR. THE PATIENT WAS NOT HARMED OR INJURED AS A RESULT OF THE REPORTED EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 828851 | HT70 PLUS VENTILATOR | CONTINUOUS VENTILATOR | CBK | NEWPORT MEDICAL INSTRUMENTS, INC | HT70 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |