FDA Adverse Event Malfunction Summary report: N

ADULT INSPIRATORY HEATED BREATHING CIRCUIT

MDR report key: 1497186 · Received August 21, 2009

Report

Report Number
9611451-2009-00464
Event Type
Malfunction
Date Received
August 21, 2009
Date of Event
July 13, 2009
Report Date
July 23, 2009
Manufacturer
FISHER & PAYKEL HEALTHCARE, LTD.
Product Code
BTT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE PRODUCT IS NOT SOLD IN THE USA BUT IT IS SIMILAR TO A PRODUCT WHICH IS SOLD IN THE USA. THE 510(K) FOR THAT PRODUCT IS K983112. THE RT206 BREATHING CIRCUIT IS EN ROUTE TO FISHER & PAYKEL HEALTHCARE FOR INVESTIGATION. WE WILL PROVIDE A FOLLOW-UP REPORT UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

A HOSPITAL IN (B)(6) REPORTED VIA A DISTRIBUTOR THAT AN RT206 ADULT BREATHING CIRCUIT DID NOT WARM WHEN THEY BEGAN USING IT. NO PATIENT CONSEQUENCE WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADULT INSPIRATORY HEATED BREATHING CIRCUIT BTT FISHER & PAYKEL HEALTHCARE, LTD. RT206

Patients

Seq Age Sex Outcome Treatment
1