FDA Adverse Event Malfunction Summary report: N

EVAQUA INFANT BREATHING CIRCUIT

MDR report key: 1061533 · Received June 17, 2008

Report

Report Number
9611451-2008-00369
Event Type
Malfunction
Date Received
June 17, 2008
Report Date
May 23, 2008
Manufacturer
FISHER & PAYKEL HEALTHCARE, LTD.
Product Code
BZE
PMA / PMN Number
K34026
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE RT235 INFANT BREATHING CIRCUIT IS CURRENT EN ROUTE TO THE MANUFACTURER FOR INVESTIGATION. NO RESULTS AND CONCLUSIONS ARE THEREFORE AVAILABLE AT PRESENT. A FOLLOW-UP REPORT WILL BE PREPARED AND FORWARDED AS SOON AS THE DEVICE HAS BEEN RETURNED AND INVESTIGATION RESULTS BECOME AVAILABLE.

Description of Event or Problem · 1

A HEALTHCARE FACILITY IN ANOTHER COUNTRY, REPORTED TO OUR DISTRIBUTOR THAT AN RT235 INFANT BREATHING CIRCUIT DID NOT PASS THE VENTILATOR LEAK TEST WHEN CONNECTED TO AN AVEA VENTILATOR DURING SET-UP. NO PATIENT CONSEQUENCE WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EVAQUA INFANT BREATHING CIRCUIT BZE FISHER & PAYKEL HEALTHCARE, LTD. RT235

Patients

Seq Age Sex Outcome Treatment
1 AVEA VENTILATOR