FDA Adverse Event Malfunction Summary report: N

V60 VENTILATOR

MDR report key: 8785798 · Received July 12, 2019

Report

Report Number
2031642-2019-04495
Event Type
Malfunction
Date Received
July 12, 2019
Report Date
June 27, 2019
Manufacturer
RESPIRONICS CALIFORNIA, INC
Product Code
MNT
PMA / PMN Number
K082660
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

G4: 01OCT2019 B4: 01OCT2019 THE MANUFACTURER¿S SERVICE TECHNICIAN CONFIRMED THE REPORTED NAV RING ISSUE. THE MANUFACTURER¿S INTERNATIONAL SERVICE TECHNICIAN REPLACED THE NAV RING TO ADDRESS THE REPORTED PROBLEM. THE UNIT WAS CHECKED OVERALL, RUN IN TESTED, CLEANED AND FUNCTIONALLY TESTED AND NO ABNORMALITY WAS CONFIRMED. SUBMISSION OF A REPORT DOES NOT CONSTITUTE AN ADMISSION THAT MEDICAL PERSONNEL, USER FACILITY, IMPORTER, DISTRIBUTOR, MANUFACTURER, OR PRODUCT CAUSED OR CONTRIBUTED TO THE EVENT.

Description of Event or Problem · 0

NAV RING FAILURE. THERE WAS NO PATIENT INVOLVEMENT.

Additional Manufacturer Narrative · 1

DATE OF EVENT: (B)(6) 2019. DATE OF REPORT: 11JULY2019. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION HAS BEEN COMPLETE.

Description of Event or Problem · 1

NAV RING FAILURE. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
580732 V60 VENTILATOR VENTILATOR, CONTINUOUS, MINIMAL VENTILATORY SUPPORT,FACILITY USE MNT RESPIRONICS CALIFORNIA, INC V60

Patients

Seq Age Sex Outcome Treatment
1