FDA Adverse Event Injury Summary report: N

MEDISORB

MDR report key: 22137579 · Received June 3, 2025

Report

Report Number
1314417-2025-00036
Event Type
Injury
Date Received
June 3, 2025
Date of Event
May 8, 2025
Report Date
July 23, 2025
Manufacturer
AIRLIFE
Product Code
CBL
UDI-DI
10190752184329
PMA / PMN Number
N/A
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ALL INFORMATION REASONABLY KNOWN AS OF 03 JUNE 2025 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AIRLIFE. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AIRLIFE. AIRLIFE. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AIRLIFE COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AIRLIFE PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Additional Manufacturer Narrative · 0

ALL INFORMATION REASONABLY KNOWN AS OF 03 JUNE 2025 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AIRLIFE. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AIRLIFE. AIRLIFE. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AIRLIFE COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AIRLIFE PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY THE COMPLAINT OF "THERE ARE GRANULES GETTING PAST THE FILTER AND GOING INSIDE THE ANESTHESIA MACHINES AND CAUSING DELAYS IN PATIENT CARE. ANESTHESIA MACHINES ARE MALFUNCTIONING DUE TO THE DUST FROM THE SODASORB ENTERING THE BREATHING SYSTEM. DELAYED PROCEDURE AND ANESTHESIA MACHINES REPAIRED. " REGARDING PART M1173310 WAS NOT CONFIRMED. THE ROOT CAUSE WAS NOT DETERMINED. A RISK ASSESSMENT WAS PERFORMED, AND THE ULTIMATE RISK WAS DETERMINED TO BE LOW WHICH DOES NOT REQUIRE ESCALATION TO THE CAPA REVIEW BOARD. THERE HAVE BEEN NO OTHER COMPLAINTS REGARDING THE SAME PART AND A SIMILAR ISSUE SINCE 18NOV2024 MANUFACTURING RELEASE PRECEDING THIS REPORTED EVENT. A RESOLUTION LETTER WAS SENT TO THE CUSTOMER. COMPLAINTS WILL CONTINUE TO BE MONITORED FOR POSSIBLE TRENDS.

Description of Event or Problem · 0

THERE ARE GRANULES GETTING PAST THE FILTER AND GOING INSIDE THE ANESTHESIA MACHINES AND CAUSING DELAYS IN PATIENT CARE. ANESTHESIA MACHINES ARE MALFUNCTIONING DUE TO THE DUST FROM THE SODASORB ENTERING THE BREATHING SYSTEM. DELAYED PROCEDURE AND ANESTHESIA MACHINES REPAIRED.

Description of Event or Problem · 0

THERE ARE GRANULES GETTING PAST THE FILTER AND GOING INSIDE THE ANESTHESIA MACHINES AND CAUSING DELAYS IN PATIENT CARE. ANESTHESIA MACHINES ARE MALFUNCTIONING DUE TO THE DUST FROM THE SODASORB ENTERING THE BREATHING SYSTEM. DELAYED PROCEDURE AND ANESTHESIA MACHINES REPAIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
530672 MEDISORB MULTI-ABSORBER ORIGINAL, DISPOSABLE CBL AIRLIFE M1173310 0004309031 10190752184329

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other