FDA Adverse Event Malfunction Summary report: N

FISHER & PAYKEL HEALTHCARE

MDR report key: 19823276 · Received July 24, 2024

Report

Report Number
9611451-2024-00531
Event Type
Malfunction
Date Received
July 24, 2024
Report Date
June 28, 2024
Manufacturer
FISHER & PAYKEL HEALTHCARE LTD
Product Code
BTT
UDI-DI
09420012450029
PMA / PMN Number
SEE H11
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THE 950N81 NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT IS NOT SOLD IN THE UNITED STATES OF AMERICA (USA) BUT INSTEAD A SIMILAR PRODUCT, 950N81J NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT IS SOLD IN THE USA. THE 510(K) FOR THAT PRODUCT IS K220703. FISHER AND PAYKEL HEALTHCARE (F&P) HAS REQUESTED THE RETURN OF THE SUBJECT (B)(6) NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT TO F&P NEW ZEALAND FOR INVESTIGATION. WE WILL PROVIDE A FOLLOW UP REPORT UPON COMPLETION OF OUR INVESTIGATION.

Additional Manufacturer Narrative · 0

(B)(4). THE 950N81 NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT IS NOT SOLD IN THE UNITED STATES OF AMERICA (USA) BUT INSTEAD A SIMILAR PRODUCT, 950N81J NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT IS SOLD IN THE USA. THE 510(K) FOR THAT PRODUCT IS K220703. CORRECTIONS: SECTION D1: BRAND NAME - CORRECTED TO "FISHER & PAYKEL HEALTHCARE" TO REFLECT GUDID. SECTION D2B: PRODUCT CODE - CORRECTED TO "BTT" TO REFLECT GUDID. SECTION D4: UDI - ADDED THE EXPIRY DETAILS TO UDI. METHOD: THE COMPLAINT 950N81 NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT WAS REQUESTED, HOWEVER WAS NOT RETURNED TO FISHER & PAYKEL HEALTHCARE (F&P) FOR EVALUATION. OUR INVESTIGATION IS THUS BASED ON THE INFORMATION, PHOTOGRAPH OF THE CIRCUIT PROVIDED BY THE HEALTHCARE FACILITY, PREVIOUS INVESTIGATIONS OF SIMILAR COMPLAINTS, AND OUR KNOWLEDGE OF THE PRODUCT. RESULTS: VISUAL INSPECTION OF THE PROVIDED PHOTOGRAPH REVEALED THAT THE COVER MIDPOINT NEO 950 OF THE NEONATAL INSPIRATORY LIMB WAS OBSERVED TO HAVE A VISIBLE GAP AT THE JOINT OF THE MIDPOINT COVER. IT IS NOT A CRACK THAT WOULD CAUSE A GAS LEAKAGE. THE COVER MIDPOINT NEO 950 IS A PURELY COSMETIC COVER AND DOES NOT IMPACT ON THE PERFORMANCE OR SAFETY OF THE INSPIRATORY LIMB IN ANY WAY. CONCLUSION: WITHOUT THE DEVICE BEING RETURNED FOR INVESTIGATION, WE ARE UNABLE TO DETERMINE THE CAUSE OF THE REPORTED EVENT. ALL 950N81 CIRCUIT KIT ARE 100% LEAK TESTED DURING PRODUCTION, AND THOSE THAT FAIL ARE REJECTED. THE USER INSTRUCTIONS WHICH ACCOMPANY THE 950N81 NEONATAL VENTED DUAL HEATED CIRCUIT KIT STATE THE FOLLOWING: "DO NOT CRUSH, STRETCH OR MILK THE TUBING." "PERFORM A PRESSURE AND LEAK TEST ON THE BREATHING SYSTEM BEFORE CONNECTING TO A PATIENT." "CHECK ALL CONNECTIONS ARE TIGHT BEFORE USE." THE USER INSTRUCTIONS ALSO WARN THE USER: SET APPROPRIATE VENTILATOR OR FLOW SOURCE ALARMS TO MONITOR THERAPY DELIVERY. APPROPRIATE PATIENT MONITORING (E.G. OXYGEN SATURATION) MUST BE USED AT ALL TIMES. FAILURE TO MONITOR THE PATIENT (E.G. IN THE EVENT OF AN INTERRUPTION TO GAS FLOW) MAY RESULT IN SERIOUS HARM OR DEATH."

Description of Event or Problem · 0

A HEALTHCARE FACILITY IN SPAIN REPORTED, VIA A FISHER & PAYKEL HEALTHCARE (F&P) FIELD REPRESENTATIVE, THAT THE 950N81 NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT WAS LEAKING DURING PATIENT USE. NO PATIENT CONSEQUENCES WERE REPORTED. HEALTHCARE FACILITY FURTHER REPORTED THAT THERE WAS NO VISIBLE DAMAGE ON THE CIRCUIT.

Description of Event or Problem · 0

A HEALTHCARE FACILITY IN SPAIN REPORTED, VIA A FISHER & PAYKEL HEALTHCARE (F&P) FIELD REPRESENTATIVE, THAT THE 950N81 NEONATAL VENTILATOR DUAL HEATED CIRCUIT KIT WAS LEAKING DURING PATIENT USE. NO PATIENT CONSEQUENCES WERE REPORTED. HEALTHCARE FACILITY FURTHER REPORTED THAT THERE WAS NO VISIBLE DAMAGE ON THE CIRCUIT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
357342 FISHER & PAYKEL HEALTHCARE BZE BTT FISHER & PAYKEL HEALTHCARE LTD 950N81 2102958913 09420012450029

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown