| Brand Name | INFINITY ACS WORKSTATION CC |
| Common Device Name | VENTILATOR, INTENSIVE CARE |
| Manufacturer (Section D) |
| DRÄGERWERK AG & CO. KGAA |
| moislinger allee 53-55 |
| lübeck |
| GM |
|
| Manufacturer (Section G) |
| DRÄGERWERK AG & CO. KGAA |
| moislinger allee 53-55 |
|
| lübeck 23558 |
|
GM
23558
|
|
| Manufacturer Contact |
|
|
| moislinger allee 53-55 |
| lübeck 23558
|
|
4518822868
|
|
| MDR Report Key | 24978999 |
| Report Number | 9611500-2026-00175 |
| Device Sequence Number | 21202515 |
| Product Code |
CBK
|
| UDI-Device Identifier | 04048675042266 |
| UDI-Public | (01)04048675042266(11)200813(93)8416400-21 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K093633 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Company Representative |
| Initial Reporter Occupation |
Biomedical Engineer
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
05/26/2026 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Model Number | 8416000 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Follow-Up |
| Initial Date Received by Manufacturer | 03/27/2026 |
| Supplement Date Received by Manufacturer | 05/21/2026
|
| Initial Report FDA Received Date | 04/24/2026 |
| Supplement Report FDA Received Date | 05/26/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 08/13/2020 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | NA. |
| Patient Sex | Unknown |