FDA Adverse Event
Injury
Summary report: N
SPIRO
MDR report key: 23107146
·
Received September 22, 2025
Report
- Report Number
- 3014054118-2023-00002
- Event Type
- Injury
- Date Received
- September 22, 2025
- Date of Event
- March 10, 2023
- Report Date
- September 17, 2025
- Manufacturer
- FOGLESS INTERNATIONAL AB
- Product Code
- JOH
- PMA / PMN Number
- K122932
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- PHARMACIST
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
THE EVENT DID NOT INVOLVE A MALFUNCTION OF THE SPIRO SPEAKING VALVE. THE USER FAILED TO FOLLOW THE MANUFACTURER'S LABELLING, INCLUDING A CAUTION SYMBOL PRINTED ON THE DEVICE, AND THE BOLD WARNING TEXT IN THE INSTRUCTIONS FOR USE "NEVER PLACE A SPEAKING VALVE ON A TRACHEAL CANNULA THAT HAS AN INFLATED CUFF AND IS NOT FENESTRATED".
Description of Event or Problem · 0
CONFUSION WITH A SPEAKING VALVE AND HEAT MOISTURE EXCHANGER. THE SPEAKING VALVE WAS PLACED ON NON-FENESTRATED CUFFED CANNULA. RESULT: BRADYCARDIA. INTERVENTION: SPEAKING VALVE REPLACED WITH HEAT MOISTURE EXCHANGER - THE PATIENT QUICKLY SATURATES TO 95 THEN 98% UNDER 15L OF OXYGEN - PLACEMENT OF A 20F CHEST DRAIN WITH SIGNIFICANT AIR RELEASE DURING PLACEMENT - RESUMPTION OF MECHANICAL VENTILATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2655203 | SPIRO | SPEAKING VALVE WITH OXYGEN NIPPLE | JOH | FOGLESS INTERNATIONAL AB | 710 | 5377 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Life Threatening| R |