FDA Adverse Event Malfunction Summary report: N

VENTLAB

MDR report key: 23045531 · Received September 12, 2025

Report

Report Number
1314417-2025-00070
Event Type
Malfunction
Date Received
September 12, 2025
Date of Event
August 13, 2025
Report Date
February 20, 2026
Manufacturer
VENT LAB LLC
Product Code
BTM
UDI-DI
10889483081181
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE ACTUAL COMPLAINT PRODUCT WAS NOT RETURNED FOR EVALUATION; HOWEVER, THE REPORTER PROVIDED PHOTOGRAPHIC/VIDEOGRAPHIC EVIDENCE; ANALYSIS OF THE PHOTOGRAPHIC EVIDENCE DID NOT CONFIRM THE COMPLAINT AS REPORTED. THE DEVICE HISTORY RECORD FOR LOT 533733 WAS REVIEWED AND THE PRODUCT WAS PRODUCED ACCORDING TO PRODUCT SPECIFICATIONS. ALL INFORMATION REASONABLY KNOWN AS OF 12 SEP 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 SUN MED HOLDINGS LLC. 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 SUN MED HOLDINGS LLC. SUN MED HOLDINGS LLC. 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 SUN MED HOLDINGS COMPLAINT DATABASE AND IDENTIFIED AS (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 SUN MED HOLDINGS LLC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Additional Manufacturer Narrative · 0

THE ACTUAL COMPLAINT PRODUCT WAS NOT RETURNED FOR EVALUATION; HOWEVER, THE REPORTER PROVIDED PHOTOGRAPHIC/VIDEOGRAPHIC EVIDENCE; ANALYSIS OF THE PHOTOGRAPHIC EVIDENCE DID NOT CONFIRM THE COMPLAINT AS REPORTED. THE DEVICE HISTORY RECORD FOR LOT 533733 WAS REVIEWED AND THE PRODUCT WAS PRODUCED ACCORDING TO PRODUCT SPECIFICATIONS. ALL INFORMATION REASONABLY KNOWN AS OF 12 SEP 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 SUN MED HOLDINGS LLC. 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 SUN MED HOLDINGS LLC. SUN MED HOLDINGS LLC. 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 SUN MED HOLDINGS COMPLAINT DATABASE AND IDENTIFIED AS (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 SUN MED HOLDINGS LLC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Description of Event or Problem · 0

IT WAS REPORTED: AIR WAS NOT FLOWING THROUGH THE BAG, THE RESPIRATORY THERAPIST (RT) PUT WATER INTO [THE BAG] TO TEST IT; WATER LEAKED OUT OF THE LOWER PORTION OF THE BAG. THIS RESULTED IN DELAY IN TREATMENT AS THEY HAD TO OPEN UP ANOTHER BAG; HOWEVER, THERE WAS NO REPORTED INJURY.

Description of Event or Problem · 0

IT WAS REPORTED: AIR WAS NOT FLOWING THROUGH THE BAG, THE RESPIRATORY THERAPIST (RT) PUT WATER INTO [THE BAG] TO TEST IT; WATER LEAKED OUT OF THE LOWER PORTION OF THE BAG. THIS RESULTED IN DELAY IN TREATMENT AS THEY HAD TO OPEN UP ANOTHER BAG; HOWEVER, THERE WAS NO REPORTED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
270618 VENTLAB AIRFLOW PEDIATRIC RESUSCITATOR WITH INTEGRATED MANOMETER BTM VENT LAB LLC AF2142MC 533733 10889483081181

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown