| Brand Name | SERVO-S BASE UNIT |
| Common Device Name | VENTILATOR, CONTINUOUS, FACILITY USE |
| Manufacturer (Section D) |
| MAQUET CRITICAL CARE AB |
| roentgenvagen 2 |
| solna |
|
| Manufacturer (Section G) |
| MAQUET CRITICAL CARE AB |
| roentgenvagen 2 |
|
| solna |
|
| Manufacturer Contact |
|
caroline
kabbabe
|
| roentgenvagen 2 |
| solna
|
|
| MDR Report Key | 25545205 |
| Report Number | 8010042-2026-0000821 |
| Device Sequence Number | 5649686 |
| Product Code |
CBK
|
| UDI-Device Identifier | 07325710001127 |
| UDI-Public | (01)07325710001127(11)180709 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | IN |
| PMA/510(K) Number | K123149 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | Y |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility,Company Representative,Distributor |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/18/2026 |
| 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 | 6640440 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/13/2026 |
| Supplement Date Received by Manufacturer | 06/30/2026
|
| Initial Report FDA Received Date | 06/18/2026 |
| Supplement Report FDA Received Date | 06/30/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 07/09/2018 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|