FDA Adverse Event Injury Summary report: N

VELA VENTILATOR

MDR report key: 6248371 · Received January 12, 2017

Report

Report Number
2021710-2017-05208
Event Type
Injury
Date Received
January 12, 2017
Date of Event
October 24, 2016
Report Date
May 30, 2017
Manufacturer
CAREFUSION, INC
Product Code
CBK
PMA / PMN Number
K093094
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

RESULTS OF INVESTIGATION: CAREFUSION FAILURE ANALYSIS LAB TECHNICIAN WAS ABLE TO VERIFY AND DUPLICATE THE CUSTOMER'S REPORTED ISSUE. THE PT802 TRANSDUCER WAS SUCCESSFULLY CALIBRATED, BUT THE ODV WAS AT THE MAXIMUM SPECIFICATION. ALSO THE 0 CMH2O = 690 CALIBRATION COUNT WAS 690 WHICH IS THE MAXIMUM ALLOWABLE VALUE.

Additional Manufacturer Narrative · 1

IN THE EVENT THE DEVICE IS RECEIVED FOR EVALUATION OR ADDITIONAL INFORMATION IS RECEIVED A FOLLOW-UP REPORT WILL BE SUBMITTED. AT THIS TIME, CAREFUSION HAS NOT RECEIVED THE SUSPECT DEVICE/COMPONENT FROM THE CUSTOMER FOR EVALUATION. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING PATIENT USE THE VENTILATOR ALARMED TRANSDUCER FAULT. THE VENTILATOR WAS TAKEN OFF THE PATIENT AND THERE WAS NO HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
30703 VELA VENTILATOR VENTILATOR, CONTINUOUS, FACILITY USE CBK CAREFUSION, INC VELA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention