Brand Name | DREAM STATION AUTO CPAP HUMHTCELL DOM |
Type of Device | VENTILATOR, NON-CONTINUOUS (RESPIRATOR) |
Manufacturer (Section D) |
PHILIPS / RESPIRONICS, INC |
|
|
MDR Report Key | 18704405 |
MDR Text Key | 335461727 |
Report Number | MW5151579 |
Device Sequence Number | 1 |
Product Code |
BZD
|
Combination Product (y/n) | N |
Reporter Country Code | US |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Voluntary
|
Reporter Occupation |
Patient
|
Type of Report
| Initial |
Report Date |
02/08/2024 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 02/13/2024 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Lay User/Patient
|
Device Expiration Date | 07/16/2018 |
Device Model Number | DSX500T 11C |
Was Device Available for Evaluation? |
Yes
|
Patient Sequence Number | 1 |
Treatment | BD NEEDLES; CEPHALEXIN ; DICLOFENAC ; ESOMEPRAOLE ; FAMOTIDINE ; GABAPENTIN ; LAMOTRIGINE ; LIRGLUTIDE ; MENS VITAMINS; NALOXONE ; NORCO CYCLOBENZAPRINE ; OXYCODONE ; POLYETHYLENE GLYCOL ; PRAZOSIN ; QUETIAPINE; TYLENOL WITH HYDROCODONE |
Patient Outcome(s) |
Other;
|
Patient Age | 37 YR |
Patient Sex | Male |
Patient Weight | 111 KG |
Patient Ethnicity | Non Hispanic |
Patient Race | American Indian Or Alaskan Native, White |