FDA Adverse Event Malfunction Summary report: N

AVEA

MDR report key: 1870036 · Received October 8, 2010

Report

Report Number
1870036
Event Type
Malfunction
Date Received
October 8, 2010
Date of Event
July 13, 2010
Report Date
October 8, 2010
Manufacturer
VIASYS/CAREFUSION
Product Code
CBK
Product Problem
Yes
Report Source
User Facility report
Reporter Location
IL, US

Narratives

Description of Event or Problem · 1

WHEN THE VENTILATOR CAME INTO THE SHOP FOR ROUTINE SERVICE, A BLACK DUST WAS NOTED IN THE NEBULIZER TUBING LEADING TO THE PATIENT CIRCUIT. THIS IS THE SECOND INSTANCE IN 3 YEARS WHERE THIS SYMPTON WAS NOTED IN AN AVEA VENTILATOR. THE BIOMEDICAL ENGINEER (BIOMED) SUSPECTS SOME TYPE OF DETERIORATION INSIDE THE NEBULIZER PUMP ASSEMBLY. THE BIOMED HAS CONCERNS THAT THERE IS NO RECOMMENDED FILTER ON THE NEBULIZER PORT TO CATCH/STOP THIS DUST FROM GOING INTO THE PATIENT CIRCUIT.====================== HEALTH PROFESSIONAL'S IMPRESSION======================DETERIORATION OF A SEAL INSIDE THE NEBULIZER ASSEMBLY IS CREATING A BLACK DUST THAT FINDS ITS WAY INTO THE PATIENT CIRCUIT AND ULTIMATELY INTO THE PATIENT.====================== MANUFACTURER RESPONSE FOR VENTILATOR, AVEA======================WE HAVE COMPLETED THE INVESTIGATION OF THE RETURNED NEBULIZER. OUR FINDINGS ARE AS FOLLOWS. FAILURE ANALYSIS: VERIFIED THE REPORTED ISSUE, THE ASSEMBLY WAS FULLY DISASSEMBLED AND FOUND "BLACK DUST" INTERNALLY. THIS DUST WAS FROM THE SEAL AROUND THE INNER PISTON ASSEMBLY. THE CAUSE OF THIS WAS MOST LIKELY DUE TO AN OUT OF SPECIFICATION INNER CYLINDER DIAMETER NEB HOUSING. THIS SPECIFICATION DISCREPANCY CAUSED THE PISTON AND SEAL TO GRIND AGAINST THE INNER CYLINDER RESULTING IN THE SEAL BECOMING PLIABLE AND RUBBING AGAINST THE INNER WALL. SINCE BOTH THE PISTON ASSEMBLY AND INNER SURFACE OF THE CYLINDER BLOCK ARE PHYSICALLY DAMAGED NO MEASUREMENTS COULD BE TAKEN. FINDINGS/ROOT-CAUSE: POSSIBLE BORING ISSUE OF THE NEBULIZER MANIFOLD BLOCK.NO RECOMMENDATIONS FOR PREVENTION OR SAFETY PRECAUTIONS FOR THE PATIENT (FILTER ON NEBULIZER PORT) WERE GIVEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AVEA VENTILATOR, CONTINUOUS, FACILITY USE CBK VIASYS/CAREFUSION 17212-00 NA

Patients

Seq Age Sex Outcome Treatment
1 *