FDA Adverse Event Malfunction Summary report: N

INFANT BIAS FLOW BREATHING CIRCUIT

MDR report key: 1030342 · Received April 15, 2008

Report

Report Number
9611451-2008-00182
Event Type
Malfunction
Date Received
April 15, 2008
Report Date
March 13, 2008
Manufacturer
FISHER & PAYKEL HEALTHCARE, LTD.
Product Code
BTT
PMA / PMN Number
K020332
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT IS NOT SOLD IN THE USA BUT IT IS SIMILAR TO A PRODUCT WHICH IS SOLD IN THE USA. THE PRODUCT INVOLVED IN THE COMPLAINT WAS NOT RETURNED FOR INSPECTION. AN INVESTIGATION WAS CARRIED OUT BASED ON THE EVENT DESCRIPTION AND PREVIOUS EXPERIENCE OF SIMILAR COMPLAINTS. RESULTS: THE COMPONENT WAS MOST LIKELY OMITTED DURING OUR PACKING PROCESS. OUR RECORDS INDICATE THAT NO OTHER COMPLAINTS OF THIS NATURE HAVE BEEN RECEIVED FOR THIS LOT NUMBER. CONCLUSION: OUR MONITORING AND TRENDING FOR THIS TYPE OF EVENT SHOWS A RATE OF OCCURRENCE OF 0.0026% WORLDWIDE FOR THE LAST YEAR.

Description of Event or Problem · 1

OUR DISTRIBUTOR REPORTED THAT A PART WAS MISSING FROM AN RT125 INFANT BIAS FLOW BREATHING CIRCUIT. THIS WAS FOUND DURING THEIR INCOMING GOODS INSPECTION. NO PATIENT CONSEQUENCE WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INFANT BIAS FLOW BREATHING CIRCUIT BTT FISHER & PAYKEL HEALTHCARE, LTD. RT125 070423

Patients

Seq Age Sex Outcome Treatment
1