FDA Adverse Event Malfunction Summary report: N

SUNMED HOLDINGS LLC

MDR report key: 15987832 · Received December 15, 2022

Report

Report Number
1314417-2022-00023
Event Type
Malfunction
Date Received
December 15, 2022
Date of Event
November 13, 2022
Report Date
December 15, 2022
Manufacturer
SUNMED HOLDINGS LLC
Product Code
BTM
UDI-DI
10889483074725
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE RESUSCITATOR HAD NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG. THIS WAS AN INTERRUPTION IN RESUSCITATION EFFORTS. THE CLINICIAN WAS UNABLE TO PROVIDE VENTILATION TO THE PATIENT AND HAD TO GET A REPLACEMENT RESUSCITATION BAG.

Additional Manufacturer Narrative · 0

THE RESUSCITATOR HAD NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG. THIS WAS AN INTERRUPTION IN RESUSCITATION EFFORTS. THE CLINICIAN WAS UNABLE TO PROVIDE VENTILATION TO THE PATIENT AND HAD TO GET A REPLACEMENT RESUSCITATION BAG. SUMMARY: RETURNED PRODUCT CONFIRMS COMPLAINT. PRODUCT WAS FOUND TO BE MISSING A DUCKBILL VALVE WHICH PREVENTED ANY PRESSURE TO BE DELIVERED TO THE PATIENT PORT. CUSTOMER NOTIFIED OF DEFECT, MITIGATION PROCESS OUTLINED IN IFU, AND DEFECT RATES. RA: RISK ASSESSMENT REVIEW OF RMA-20020, R37 IDENTIFIES THAT MISSING COMPONENTS (LIKE THE TAIL ASSEMBLY UMBRELLA VALVE) ARE ASSOCIATED WITH A SEVERITY OF 7.

Description of Event or Problem · 0

THE PATIENT WAS IN CRITICAL CONDITION IN THE ICU REQUIRING EMERGENT INTUBATION. FOLLOWING ADMINISTRATION OF RSI DRUGS, BVM VENTILATION WAS CARRIED OUT WITH NOTED CHEST RISE THIS WAS THE FIRST USE FOR THE RESUSCITATION BAG. THE PATIENT WAS INTUBATED AND VENTILATION WAS RESUMED WITH RESUSCITATION BAG. THE PATIENT THEN BEGAN TO DETERIORATE SUDDENLY. OXYGEN SATURATION WAS DECREASING AND BREATH SOUNDS COULD NOT BE VERIFIED. THERE WAS NO CHEST RISE. THE ENDOTRACHEAL TUBE WAS VISUALIZED TO BE IN PROPER POSITION. IT WAS NOTED THAT THERE WAS NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG. THE BAG WAS DISCONNECTED AND THE BAG WAS SQUEEZED WHILE OCCLUDING PATIENT PORT. AGAIN, THERE WAS NO PRESSURE MEASUREMENT ON THE MANOMETER. STAFF OBTAINED A REPLACEMENT RESUSCITATION BAG AND RESUMED VENTILATION WITH IMMEDIATE IMPROVEMENT IN THE PATIENT CONDITION AND CHEST RISE AND BILATERAL BREATH SOUNDS WERE VERIFIED. PATIENT WAS STABILIZED AFTER APPROXIMATELY 2 MINUTES OF TROUBLESHOOTING AND TIME TO OBTAIN REPLACEMENT RESUSCITATION BAG. THERE WAS NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG.

Description of Event or Problem · 0

THE PATIENT WAS IN CRITICAL CONDITION IN THE ICU REQUIRING EMERGENT INTUBATION. FOLLOWING ADMINISTRATION OF RSI DRUGS, BVM VENTILATION WAS CARRIED OUT WITH NOTED CHEST RISE THIS WAS THE FIRST USE FOR THE RESUSCITATION BAG. THE PATIENT WAS INTUBATED AND VENTILATION WAS RESUMED WITH RESUSCITATION BAG. THE PATIENT THEN BEGAN TO DETERIORATE SUDDENLY. OXYGEN SATURATION WAS DECREASING AND BREATH SOUNDS COULD NOT BE VERIFIED. THERE WAS NO CHEST RISE. THE ENDOTRACHEAL TUBE WAS VISUALIZED TO BE IN PROPER POSITION. IT WAS NOTED THAT THERE WAS NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG. THE BAG WAS DISCONNECTED AND THE BAG WAS SQUEEZED WHILE OCCLUDING PATIENT PORT. AGAIN, THERE WAS NO PRESSURE MEASUREMENT ON THE MANOMETER. STAFF OBTAINED A REPLACEMENT RESUSCITATION BAG AND RESUMED VENTILATION WITH IMMEDIATE IMPROVEMENT IN THE PATIENT CONDITION AND CHEST RISE AND BILATERAL BREATH SOUNDS WERE VERIFIED. PATIENT WAS STABILIZED AFTER APPROXIMATELY 2 MINUTES OF TROUBLESHOOTING AND TIME TO OBTAIN REPLACEMENT RESUSCITATION BAG. THERE WAS NO PRESSURE REGISTERING ON THE MANOMETER WHILE SQUEEZING THE RESUSCITATION BAG.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2514084 SUNMED HOLDINGS LLC SM ADULT W/MAN,MASK AND PEEP BTM SUNMED HOLDINGS LLC AF5140MBP 2103291 10889483074725

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other