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