Description of Event or Problem · 0
EVENT #1: DEFECTIVE OXYTOTE GAUGE READING IN ED TANK. TANK GAUGE WAS READING INCORRECTLY AND ALARMING. GAUGE IS DISPLAYING TWO DIFFERENT READINGS. TANK WAS TAKEN OUT OF SERVICE AND TAGGED TO BE RETURNED TO GAS COMPANY. THIS IS RELATED TO A SAFETY NOTICE ISSUED BY WESTERN BUT THEY GAUGES REMAIN FAULTY IN OUR FIELD OVER A YEAR LATER AND ARE TOLD THEY WILL NOT GET TO REPAIR THE ENTIRETY OUR FLEET FOR OVER A YEAR. EVENT #2 (SAME DATE): PATIENT WAS BEING TRANSPORTED TO ULTRASOUND. HE WAS ON 2-3L NC. PATIENT WAS PLACED ON THE PORTABLE TANK FOR TRANSPORT. THE TANK WAS TURNED TO 3L BUT, THE TANK WAS NOT SWITCHED TO "ON" DURING TRANSPORT. PATIENT RETURNED TO TREATMENT ROOM WITH OXYGEN SATURATION 86-88% ON ROOM AIR. HE WAS PLACED BACK ON NASAL CANNULA AT THAT TIME AND HIS OXYGEN SATURATION IMPROVED. WHILE THIS IS RELATED TO USER ERROR, ITS DESIGN OF A TWO STEP TURN-ON PROCESS (NORMALLY ONE STEP WITHOUT GAUGE) CONTRIBUTES TO MANY FAILURES TO DELIVER OXYGEN. MANUFACTURER RESPONSE FOR OXYGEN GAUGE, OXYTOTE (PER SITE REPORTER). THIS IS RELATED TO A SAFETY NOTICE ISSUED BY WESTERN BUT THEY GAUGES REMAIN FAULTY IN OUR FIELD OVER A YEAR LATER AND ARE TOLD THEY WILL NOT GET TO REPAIR THE ENTIRETY OUR FLEET FOR OVER A YEAR.