FDA Adverse Event Malfunction Summary report: N

HBO VENT, MODEL HV-500A

MDR report key: 1935806 · Received December 3, 2010

Report

Report Number
2020676-2010-00033
Event Type
Malfunction
Date Received
December 3, 2010
Date of Event
November 5, 2010
Report Date
December 3, 2010
Manufacturer
SECHRIST INDUSTRIES, INC.
Product Code
CBK
PMA / PMN Number
K832508
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE RECEIVED AND IS CURRENTLY UNDER EVALUATION. RESULTS TO BE PROVIDED WHEN COMPLETED.

Description of Event or Problem · 1

DURING THE DECOMPRESSION STATE IN THE CHAMBER THE EXHALATION PHASE ON THE HBO VENTILATOR STUCK CAUSING IT TO STAY CLOSED. THIS IN TURN CAUSED THE VENT TO NOT CYCLE OVER THE EXHALATION RESULTING IN PROLONGED ELEVATED AIRWAY PRESSURES. PERFUSIONIST REPORTED HE IS NOT SURE WHICH PATIENT USED WITH WHICH VENT. TREATMENT DATE: (B)(6) 2010. TREATED FOR CARBON MONOXIDE POISONING. NO CARDIAC EMBARRASSMENT (SATURATION LEVELS DID NOT DROP OFF). THE PROBLEM WAS CAUGHT QUICKLY AND VENTILATOR WAS CUT-OFF AND THEN WAS MANUALLY VENTILATED. THE VENTILATOR WAS IMMEDIATELY PULLED OUT OF SERVICE.

Additional Manufacturer Narrative · 2

DEVICE RECEIVED AND IS CURRENTLY UNDER EVALUATION. RESULTS TO BE PROVIDED WHEN COMPLETED.

Description of Event or Problem · 2

DURING THE DECOMPRESSION STATE IN THE CHAMBER THE EXHALATION PHASE ON THE HBO VENTILATOR STUCK CAUSING IT TO STAY CLOSED. THIS IN TURN CAUSED THE VENT TO NOT CYCLE OVER THE EXHALATION RESULTING IN PROLONGED ELEVATED AIRWAY PRESSURES. PERFUSIONIST REPORTED HE IS NOT SURE WHICH PATIENT USED WITH WHICH VENT. TREATMENT DATE: (B)(6) 2010. TREATED FOR CARBON MONOXIDE POISONING. THE PATIENT DID DEVELOP ARRYTHMIA CARDIAC AND HAD TO BE MANUALLY VENTILATED WHEN SHE WAS BROUGHT OUT OF THE CHAMBER SO THAT HER HEART RATE COULD BE BROUGHT BACK UP. HER HEART RATE WENT DOWN TO 50.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HBO VENT, MODEL HV-500A NONE CBK SECHRIST INDUSTRIES, INC. 500A VENT

Patients

Seq Age Sex Outcome Treatment
1 37 YR Required Intervention
2 74 YR