FDA Adverse Event Malfunction Summary report: N

SERVO-S

MDR report key: 8142028 · Received December 7, 2018

Report

Report Number
8010042-2018-00657
Event Type
Malfunction
Date Received
December 7, 2018
Report Date
May 10, 2019
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K123149
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF MAQUET CRITICAL CARE AB (MANUFACTURER). REF. EXEMPTION #: E2018003 GETINGE USA SALES, LLC 45 BARBOUR POND DRIVE WAYNE, NJ 07470 CONTACT PERSON: (B)(4).

Additional Manufacturer Narrative · 0

GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF MAQUET CRITICAL CARE AB (MANUFACTURER). REF. EXEMPTION #: E2018003. GETINGE USA SALES, LLC (B)(4). CONTACT PERON: (B)(4). THE INVESTIGATION REGARDING THE REPORTED COMPLAINT HAS BEEN FINALIZED. THE UNIT WAS INVESTIGATED BY OUR FIELD SERVICE ENGINEER (FSE). CLEANING THE UNIT, AND REPLACING THE CONTROL PC (PRINTED CIRCUIT) BOARD SOLVED THE PROBLEM, THE REPLACED PC BOARD WAS RETURNED FOR INVESTIGATION. OUR INVESTIGATION OF THE RETURNED CONTROL PC BOARD DID NOT REVEAL ANY ERRORS. THE PC BOARD FUNCTION WAS ACCORDING SPECIFICATIONS. THE CAUSE TO THE REPORTED ERROR IS DEEMED TO BE RELATED TO THE CLEANING AND MAINTENANCE ROUTINES AND NOT DUE TO A DEVICE MALFUNCTION.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE VENTILATOR FAILED THE PRESSURE TRANSDUCER TEST DURING PRE-USE CHECK. THERE WAS NO PATIENT INVOLVEMENT. (B)(4).

Description of Event or Problem · 0

IMPORTER REF. #: (B)(4). MANUFACTURER REF. #: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
980318 SERVO-S VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1