FDA Adverse Event Malfunction Summary report: N

HUDSON HEATED WIRE VENTILATOR CIRCUIT

MDR report key: 1933871 · Received December 7, 2010

Report

Report Number
3004365956-2010-00350
Event Type
Malfunction
Date Received
December 7, 2010
Report Date
November 16, 2010
Manufacturer
TELEFLEX MEDICAL
Product Code
BZO
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT HAS BEEN RECEIVED BY MFR FOR EVAL, HOWEVER, INVESTIGATION REPORT IS INCOMPLETE AT THIS TIME. A FOLLOW-UP INVESTIGATION REPORT WILL BE SENT WHEN COMPLETED.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CIRCUIT MELTED WHILE ON A TRACH PT. THE CIRCUIT WAS BEING USED WHILE HEATED HUMIDIFICATION WAS BEING ADMINISTERED. NO PT INJURY REPORTED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1