Brand Name | DREAMSTATION AUTO SV |
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 | 15476780 |
MDR Text Key | 300565664 |
Report Number | 2518422-2022-82873 |
Device Sequence Number | 1 |
Product Code |
MNS
|
Combination Product (y/n) | N |
Reporter Country Code | AU |
PMA/PMN Number | K090539 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Consumer,Company Representative,Distributor |
Reporter Occupation |
Other
|
Remedial Action |
Recall |
Type of Report
| Initial |
Report Date |
09/23/2022 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Lay User/Patient
|
Device Model Number | DEX900S13 |
Device Catalogue Number | DEX900S13 |
Was Device Available for Evaluation? |
No
|
Initial Date Manufacturer Received |
09/14/2022
|
Initial Date FDA Received | 09/24/2022 |
Was Device Evaluated by Manufacturer? |
No
|
Date Device Manufactured | 03/09/2017 |
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 |
Patient Outcome(s) |
Other;
|
|
|