FDA Adverse Event Malfunction Summary report: N

SPIROPERFECT

MDR report key: 17516369 · Received August 11, 2023

Report

Report Number
MW5123318
Event Type
Malfunction
Date Received
August 11, 2023
Report Date
March 10, 2011
Manufacturer
MEDIKRO OY
Product Code
BZG
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

510(K):K971336, WELCH ALLYN BECAME AWARE THROUGH A DISTRIBUTOR IN THE NETHERLANDS THAT THEIR CUSTOMER EXPERIENCED A PROBLEM WITH THE FLOW TRANSDUCERS. TWICE WHEN SHE WANTED A PATIENT TO INHALE TO START THE SPIROMETER MEASUREMENTS A SMALL PIECE OF PLASTIC CAME OFF THE TUBE. THERE WAS NO REPORT OF THE OBJECT GOING INTO THE PATIENT'S WINDPIPE/TRACHEA. WELCH ALLYN CONTACTED THE COMPLAINANT AND REQUESTED THE DEVICES TO BE RETURNED FOR FURTHER EVALUATION. TO DATE, WELCH ALLYN HAS NOT RECEIVED THE DEVICES FROM THE USER. IF WE RECEIVE THE DEVICES, WE WILL FORWARD THEM TO THE MANUFACTURER MEDIKROOY FOR EVALUATION. (B)(4). THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2192595 SPIROPERFECT SPIROMETER, DIAGNOSTIC BZG MEDIKRO OY

Patients

Seq Age Sex Outcome Treatment
1 Unknown