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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: RESPIRONICS CALIFORNIA, INC ESPRIT VENTILATOR

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RESPIRONICS CALIFORNIA, INC ESPRIT VENTILATOR Back to Search Results
Model Number V1000
Device Problem Break (1069)
Patient Problem No Patient Involvement (2645)
Event Type  malfunction  
Manufacturer Narrative
Date of event: (b)(6) 2019.Date of report: 05april2019.A follow-up report will be submitted once the investigation has been complete.
 
Event Description
The customer reported unit has a damaged top cover 4 of 8 mounting screws are damaged holding the power supply.The device was not in use at the time of the reported event; therefore, there was no patient involvement.Event date not specified, estimate used.
 
Manufacturer Narrative
Date of report : 11jul2019, date rec¿d by mfr :09jul2019.The manufacturer¿s field service engineer (fse) confirmed the reported issue.The power supply was replaced however the (central processing unit) cpu and top cover was never replaced.No further action has been made by the customer at this time to finish the additional repairs needed for the device to function.The unit remains out of service.Submission of a report does not constitute an admission that medical personnel, user facility, importer, distributor, manufacturer, or product caused or contributed to the event.
 
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Brand Name
ESPRIT VENTILATOR
Type of Device
VENTILATOR
Manufacturer (Section D)
RESPIRONICS CALIFORNIA, INC
2271 cosmos court
carlsbad CA 92011
MDR Report Key8489441
MDR Text Key141179189
Report Number2031642-2019-02115
Device Sequence Number1
Product Code CBK
Combination Product (y/n)N
PMA/PMN Number
K981072
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type user facility
Type of Report Initial,Followup
Report Date 02/12/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/05/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberV1000
Was Device Available for Evaluation? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received03/19/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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