MAUDE Adverse Event Report: RESPIRONICS, INC. REMSTAR PLUS C-FLEX; VENTILATOR, NON-CONTINUOUS (RESPIRATOR)

Model Number DS250HS

Device Problems Degraded (1153); Fire (1245); Smoking (1585)

Patient Problems Dyspnea (1816); Headache (1880); Unspecified Respiratory Problem (4464)

Event Date 03/15/2022

Event Type  malfunction  

Event Description

The manufacturer received information alleging an issue related to a cpap device's sound abatement foam.The user alleged machine caught on fire, headaches, sinus issues and difficulty breathing/short of breath.There was no report of serious patient harm or injury.The device with power accessories has not yet been returned for investigation.This issue was reported to the fda per 21 cfr 806.The device will be corrected per res 88058.

• Brand Name: REMSTAR PLUS C-FLEX
• Type of Device: VENTILATOR, NON-CONTINUOUS (RESPIRATOR)
• Manufacturer (Section D): RESPIRONICS, INC.; 1001 murry ridge lane; murrysville PA 15668
• Manufacturer (Section G): RESPIRONICS, INC.; 1001 murry ridge lane; murrysville PA 15668
• Manufacturer Contact: kimberly shelly ; 6501 living place; pittsburgh, PA 15206 ; 2673970028
• MDR Report Key: 13995512
• MDR Text Key: 288489923
• Report Number: 2518422-2022-12011
• Device Sequence Number: 1
• Product Code: BZD
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K091319
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Consumer
• Reporter Occupation: Non-Healthcare Professional
• Remedial Action: Recall
• Type of Report: Initial
• Report Date: 04/04/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Model Number: DS250HS
• Device Catalogue Number: DS250HS
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 03/15/2022
• Initial Date FDA Received: 04/04/2022
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 08/04/2011
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Removal/Correction Number: RES 88058
• Patient Sequence Number: 1