FDA Adverse Event Malfunction Summary report: N

HUDSON NEONATAL VENTILATOR CIRCUIT HEATED-WIRE

MDR report key: 1842703 · Received August 27, 2010

Report

Report Number
3004365956-2010-00247
Event Type
Malfunction
Date Received
August 27, 2010
Date of Event
August 19, 2010
Report Date
August 20, 2010
Manufacturer
TELEFLEX MEDICAL
Product Code
BZO
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRODUCT HAS NOT YET BEEN RECEIVED BY MFR FOR EVAL, THEREFORE, INVESTIGATION REPORT IS INCOMPLETE AT THIS TIME. A F/U INVESTIGATION REPORT WILL BE SENT WHEN COMPLETED.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CAP THAT OCCLUDES THE PRESSURE LINE PORT IS CRACKED AND WILL NOT PASS VENTILATOR LEAK TEST. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON NEONATAL VENTILATOR CIRCUIT HEATED-WIRE VENTILATOR CIRCUIT BZO TELEFLEX MEDICAL NA 02A1002480

Patients

Seq Age Sex Outcome Treatment
1