FDA Adverse Event Malfunction Summary report: N

INOMAX DS (DELIVERY SYSTEM)

MDR report key: 1915270 · Received November 2, 2010

Report

Report Number
3004531588-2010-00109
Event Type
Malfunction
Date Received
November 2, 2010
Date of Event
October 6, 2010
Report Date
November 2, 2010
Manufacturer
INO THERAPEUTICS LLC/IKARIA
Product Code
MRN
PMA / PMN Number
K061901
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ON (B)(6) 2010, A RESPIRATORY THERAPIST REPORTED INOMAX DS, # (B)(4) HAD ERRATIC NO READINGS. EVAL SUMMARY: THE ROOT CAUSE OF THE DELIVERY FAILURE INVOLVES FRETTING CORROSION OF CONDUCTING TRACES IN AN INTERNAL RIBBON CABLE. THE FRETTING CORROSION CAN CAUSE INTERMITTENT HIGH RESISTANCE CONNECTION TO THE CABLE'S CONNECTOR, CAUSING FLUCTUATING MONITORED (NO) READINGS. THE INTERNAL RIBBON CABLE WAS REPLACED AND IT WAS CONFIRMED THE FLUCTUATING MONITORED NO READINGS STOPPED AND WERE CORRECTED. IT IS IMPORTANT TO NOTE THAT THE MONITORED NO LEVEL WOULD BE FLUCTUATING IN THIS CASE AND NOT THE ACTUAL NO DELIVERED.

Description of Event or Problem · 1

ON (B)(6) 2010, A RESPIRATORY THERAPIST REPORTED FLUCTUATION IN NITRIC OXIDE (NO) READINGS FROM 6.8 TO 32 PARTS PER MILLION (PPM) ON INOMAX DS, # (B)(4) WHILE SET AT 20 PPM. THE RESPIRATORY THERAPIST STATES THAT THERE WAS NO HARM TO THE PT AND NO ADVERSE EVENT OCCURRED. THE DEVICE WAS REPLACED WITH ANOTHER UNIT. THE DEVICE WAS REMOVED FROM SERVICE BY THE CUSTOMER AND RETURNED TO THE COMPANY FOR INVESTIGATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INOMAX DS (DELIVERY SYSTEM) APPARATUS, NITRIC OXIDE DELIVERY MRN INO THERAPEUTICS LLC/IKARIA 10003

Patients

Seq Age Sex Outcome Treatment
1