FDA Adverse Event
Malfunction
Summary report: N
NA
MDR report key: 10801521
·
Received November 6, 2020
Report
- Report Number
- 1523658-2020-00192
- Event Type
- Malfunction
- Date Received
- November 6, 2020
- Report Date
- November 5, 2020
- Manufacturer
- BATTELLE MEMORIAL INSTITUTE
- Product Code
- QKY
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DEVICE NOT RETURNED. CCDS STAFF AND HCP ARE IN DISCUSSION PROVIDING ADDITIONAL INFORMATION CONCERNING THE DECONTAMINATION PROCESS AS WELL AS FAQS ANSWERING CUSTOMER QUESTIONS CONCERNING MASK FIT. CCDS STAFF EXPLAINED THAT UNPACKING, LOADING AND UNLOADING OF THE MASK INTO AND OUT OF THE CHAMBER THEN REPACKING INTO THE BAGS CAN HAVE AN EFFECT ON THE FIT QUALITY.
Description of Event or Problem · 1
USER REPORTED SEAL CHECKS FAIL, STRAPS SEEM TO BE STRETCHED OUT. THE MASKS ASSOCIATED WITH THIS EVENT WERE DECONTAMINATED WITH THE BATTELLE CCDS "CLOSED SYSTEM" PROCESS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1264987 | NA | RESPIRATOR, DECONTAMINATED | QKY | BATTELLE MEMORIAL INSTITUTE |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |