A hospital biomed tested the device after the reported event without findings.The log was downloaded and submitted for further analysis.Based on the information stored therein, the case in question could be reconstructed.The case in question was started at 1:19pm using man/spont and continued in volume af mode from 1:19pm.Until approx.1:55pm ventilation was unremarkable and stable.In the following initially significant circuit leaks of 1.0 l/min were measured and several apnea, volume not attained and fg low or leak alarms were given.In the further course, negative pressures (up to -16 hpa) and positive pressure peaks (up to 94 hpa) were alternating and finally, due to a too fast and too high pressure increase the ventilator performed an emergency shutdown while autonomously changing mode to man/spont and generating the respective ventilator fail alarm.It is very plausible that the reported repositioning of the patient were the root cause of the unstable pressure situation at the time of event.The investigation has not revealed any device failure.The apollo reacted as specified by stopping automatic ventilation and generating a corresponding alarm.
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