FDA Adverse Event Malfunction Summary report: N

MANUAL FILL INFANT HUMIDIFICATION CHAMBER

MDR report key: 1200104 · Received October 15, 2008

Report

Report Number
9611451-2008-00605
Event Type
Malfunction
Date Received
October 15, 2008
Report Date
September 16, 2008
Manufacturer
FISHER & PAYKEL HEALTHCARE, LTD.
Product Code
BTT
PMA / PMN Number
K913367
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS CURRENTLY EN ROUTE TO FISHER & PAYKEL HEALTHCARE 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. A LOT CHECK REVEALED ONE OTHER COMPLAINT OF THIS NATURE FOR THIS LOT NUMBER.

Description of Event or Problem · 1

A HOSPITAL REPORTED THAT A MR225 MANUAL FILL INFANT/PEDIATRIC HUMIDIFICATION CHAMBER CRACKED AS A RESULT OF BACK PRESSURE FROM THE OSCILLATOR IT WAS CONNECTED TO. NO PT CONSEQUENCE WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MANUAL FILL INFANT HUMIDIFICATION CHAMBER BTT FISHER & PAYKEL HEALTHCARE, LTD. MR225X 070524

Patients

Seq Age Sex Outcome Treatment
1