FDA Adverse Event Malfunction Summary report: N

HUDSON HUMID-VENT 2

MDR report key: 2163492 · Received June 13, 2011

Report

Report Number
8040412-2011-00086
Event Type
Malfunction
Date Received
June 13, 2011
Date of Event
May 23, 2011
Report Date
June 3, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
CAH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS NOT RECEIVED BY THE MFR AT THE TIME OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN COMPLETION OF INVESTIGATION.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: COMPLAINT ALLEGES THAT THE LARGE PORT ON THE FILTER WAS NOTICED TO BE OCCLUDED DURING USE ON A PT. COMPLAINT STATES THAT AFTER THE PT WAS INTUBATED; THE STAFF HAD PROBLEMS TRYING TO VENTILATE THE PT AND WHEN CHECKED; THE FILTER WAS NOTICED TO BE OCCLUDED. THE FILTER WAS CHANGED AND NO FURTHER ISSUES OCCURRED. PT CURRENT CONDITION IS UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON HUMID-VENT 2 HEAT & MOISTER EXCHANGER CAH TELEFLEX MEDICAL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 20 YR