FDA Adverse Event Malfunction Summary report: N

ADULT INSPIRATORY HEATED BREATHING CIRCUIT

MDR report key: 2248909 · Received September 15, 2011

Report

Report Number
9611451-2011-00573
Event Type
Malfunction
Date Received
September 15, 2011
Report Date
August 16, 2011
Manufacturer
FISHER & PAYKEL HEALTHCARE LTD
Product Code
BTT
PMA / PMN Number
SEE H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE RT226 IS NOT SOLD IN THE USA BUT IT IS SIMILAR TO A PRODUCT WHICH IS SOLD IN THE USA. THE 510(K) FOR THAT PRODUCT IS K020332. ADDITIONAL LOT DATES: 090522 - 5 UNITS, 090610 - 5 UNITS, 090622 - 3 UNITS, 090828 - 2 UNITS, 090909 - 2 UNITS, 091019 - 1 UNIT, 091021 - 2 UNITS, 091105 - 2 UNITS, 091123 - 1 UNIT, 091130 - 2 UNITS, 091212 - 1 UNIT, 091228 - 1 UNIT, 100120 - 1 UNIT, 100128 - 2 UNITS, 100316 - 1 UNIT, 100610 - 2 UNITS. WE ARE CURRENTLY ENDEAVOURING TO OBTAIN FURTHER INFORMATION WITH REGARDS TO THE COMPLAINT DEVICES. WE WILL PROVIDE A FOLLOW-UP REPORT ONCE WE RECEIVE THE COMPLAINT DEVICES AND HAVE COMPLETED OUR INVESTIGATION.

Additional Manufacturer Narrative · 1

(B)(4). THE RT226 IS NOT SOLD IN THE USA BUT IT IS SIMILAR TO A PRODUCT WHICH IS SOLD IN THE USA. THE 510(K) FOR THAT PRODUCT IS K020332. METHOD: A TOTAL OF (B)(4) COMPLAINT RT212 BREATHING CIRCUITS WERE RETURNED TO FISHER & PAYKEL HEALTHCARE (B)(4) FOR VISUAL INSPECTION. THE INSPIRATORY LIMBS OF THE COMPLAINT DEVICES WERE PERFORMANCE TESTED. RESULTS: VISUAL INSPECTION REVEALED THAT ONE COMPLAINT DEVICE HAD A MISSING HEATER WIRE PIN AND A PERFORMANCE TEST WAS NOT APPLICABLE. FULL INSERTION OF THE INSPIRATORY HEATER WIRE ADAPTER WAS ACHIEVED FOR (B)(4) COMPLAINT DEVICES AND NO FAULT WAS FOUND FOR ALL (B)(4) DEVICES. FULL INSERTION OF THE INSPIRATORY HEATER WIRE ADAPTER WAS NOT ACHIEVED FOR THE REMAINING (B)(4) COMPLAINT DEVICES, WHERE (B)(4) COMPLAINT DEVICES WERE FOUND TO HAVE A BENT INSPIRATORY HEATER WIRE PIN, AND (B)(4) COMPLAINT DEVICES WERE FOUND TO HAVE A SPLIT INSPIRATORY HEATER WIRE PIN. A LOT CHECK WAS NOT PERFORMED AS NO LOT NUMBER WAS ABLE TO BE CONFIRMED FROM THE RETURNED COMPLAINT DEVICES. CONCLUSION: ALL BREATHING CIRCUITS ARE TESTED FOR CONNECTIVITY AND ELECTRICAL CONTINUITY DURING PRODUCTION AND THOSE THAT FAIL ARE REJECTED. IT IS POSSIBLE FOR THE USER TO PHYSICALLY DAMAGE THE HEATER WIRE PINS DURING SET UP IF THE HEATER WIRE ADAPTOR IS INSERTED INTO THE HEATER WIRE PLUG ON AN ANGLE. FOR BENT OR SPLIT PINS REPORTED TO US, IT IS IMPOSSIBLE FOR US TO DETERMINE WHETHER THE PINS WERE DAMAGED DURING PRODUCTION OR BY THE END USER. (B)(4).

Description of Event or Problem · 1

A DISTRIBUTOR IN (B)(6) REPORTED ON BEHALF OF THEIR CUSTOMERS THAT THE INSPIRATORY LIMB HEATER WIRE CONNECTORS OF 41 RT212 ADULT INSPIRATORY HEATED BREATHING CIRCUIT WERE DAMAGED. THESE WERE FOUND PRIOR TO PATIENT USE.

Description of Event or Problem · 1

A DISTRIBUTOR IN (B)(4) REPORTED ON BEHALF OF THEIR CUSTOMERS THAT THE INSPIRATORY LIMB HEATER WIRE CONNECTORS OF 41 RT212 ADULT INSPIRATORY HEATED BREATHING CIRCUIT WERE DAMAGED. THESE WERE FOUND PRIOR TO PATIENT USE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADULT INSPIRATORY HEATED BREATHING CIRCUIT BTT BTT FISHER & PAYKEL HEALTHCARE LTD RT212 091118

Patients

Seq Age Sex Outcome Treatment
1