FDA Adverse Event Malfunction Summary report: N

ADULT INSPIRATORY-HEATED BREATHING CIRCUIT

MDR report key: 2582392 · Received May 21, 2012

Report

Report Number
9611451-2012-00324
Event Type
Malfunction
Date Received
May 21, 2012
Date of Event
April 13, 2012
Report Date
April 30, 2012
Manufacturer
FISHER & PAYKEL HEALTHCARE LIMITED
Product Code
BTT
PMA / PMN Number
SEE H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). LOT NUMBER: 110920, MANUFACTURING DATE: 09/20/2011, QUANTITY AFFECTED 1. LOT #:111107, MFG DATE: 11/07/2011, QTY AFFECTED: 3. LOT#: 120119, MFG DATE: 01/19/2012, QTY AFFECTED 1. THE RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT 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 K983112. THE COMPLAINT RT443 ADULT BREATHING CIRCUIT IS EN ROUTE TO FISHER & PAYKEL HEALTHCARE FOR INVESTIGATION. WE WILL PROVIDE A FOLLOW-UP REPORT ONCE WE HAVE COMPLETED OUR INVESTIGATION.

Additional Manufacturer Narrative · 1

(B)(4). LOT NUMBER: 110920, 111107, 120119; MANUFACTURING DATE: 09/20/2011, 11/07/2011, 01/19/2012; (B)(4). THE RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT 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 K983112. METHOD: THE RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT KIT WAS RETURNED TO FPH IN (B)(4) FOR INSPECTION. THE COMPLAINT 5.5 MM PRESSURE LINE OF THE RETURNED RT443 ADULT BREATHING CIRCUIT KIT WAS VISUALLY INSPECTED. THE OUTER AND INNER DIMENSIONS OF BOTH ENDS OF THE SUBJECT PRESSURE LINE WERE ALSO MEASURED USING A DIGITAL CALLIPER. RESULTS: THE RT443 ADULT BREATHING CIRCUIT KIT WAS STILL SEALED WHEN RECEIVED. THE PRESSURE LINE INSIDE THE SEALED KIT WAS DETACHED FROM THE EXHALATION TUBE. THE PRESSURE LINE ADAPTOR CONNECTION WAS ALSO LOOSE. BOTH THE OUTER DIAMETERS AND ONE OF THE INNER DIAMETERS OF THE PRESSURE LINE ENDS WERE WITHIN THE REQUIRED SPECIFICATIONS. HOWEVER, THE INNER DIAMETER OF THE PRESSURE LINE END THAT CONNECTS TO THE EXHALATION TUBE WAS SLIGHTLY LARGER THAN SPECIFICATION. A LOT CHECK REVEALED NO OTHER COMPLAINTS OF THIS NATURE FOR LOT NUMBERS 110920 AND 120119. A LOT CHECK REVEALED TWO OTHER COMPLAINTS OF THIS NATURE FOR LOT NUMBER 111107. CONCLUSION: ALTHOUGH THE INNER DIAMETER OF ONE OF THE PRESSURE LINE ENDS WAS OUTSIDE THE SPECIFICATION, IT SHOULD BE NOTED THAT IT WAS THE PRESSURE LINE END THAT WAS INSERTED INTO THE EXHALATION TUBE. ITS INNER DIAMETER WILL HAVE INCREASED DUE TO IT BEING FORCED ONTO THE EXHALATION TUBE. THE PRESSURE LINES OF THE RT443 ADULT BREATHING CIRCUITS ARE INSERTED ONTO THE EXHALATION TUBES PRIOR TO LEAVING THE PRODUCTION LINE. THIS SUGGESTS THE SUBJECT PRESSURE LINE WAS DETACHED POST PRODUCTION, POSSIBLY DURING TRANSPORTATION. OUR USER INSTRUCTIONS THAT ACCOMPANY THE RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT STATE THE FOLLOWING: "CHECK ALL CONNECTIONS ARE TIGHT BEFORE USE." "CHECK SYSTEM FOR LEAKS BEFORE CONNECTING TO PATIENT." "VERIFY CORRECT OPERATION BEFORE CONNECTING TO THE PATIENT."

Description of Event or Problem · 1

A DISTRIBUTOR IN (B)(6) REPORTED TO A FISHER & PAYKEL HEALTHCARE (FPH) FIELD REPRESENTATIVE THAT THE PRESSURE LINE OF THE EXHALATION VALVE OF AN RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT WAS "SLIPPING OFF EVERY EASY", AND SOMETIMES ALREADY DISCONNECTED WHEN RECEIVED.

Description of Event or Problem · 1

A DISTRIBUTOR IN (B)(6) REPORTED TO A FISHER & PAYKEL HEALTHCARE (FPH) FIELD REPRESENTATIVE THAT THE PRESSURE LINE OF THE EXHALATION VALVE OF AN RT443 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT WAS "SLIPPING OFF EVERY EASY", AND SOMETIMES ALREADY DISCONNECTED WHEN RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADULT INSPIRATORY-HEATED BREATHING CIRCUIT BTT BTT FISHER & PAYKEL HEALTHCARE LIMITED RT443 SEE H10

Patients

Seq Age Sex Outcome Treatment
1