FDA Adverse Event Malfunction Summary report: N

SUPER SOFT

MDR report key: 2929885 · Received January 9, 2013

Report

Report Number
2929885
Event Type
Malfunction
Date Received
January 9, 2013
Report Date
January 9, 2013
Manufacturer
WESTMED, INC.
Product Code
CAT
Product Problem
Yes
Report Source
User Facility report
Reporter Location
CA, US

Narratives

Description of Event or Problem · 1

NEW INFANT NASAL CANNULA WITH SOFT TUBING CAUSED LOUD AND HIGH PITCH NOISE WHEN ATTACHED TO OXYGEN HUMIDIFIER. THE BOTTLE WOULD BURST AND WATER WOULD SHOOT OUT ONCE THE HUMIDIFIER WAS REMOVED. CHANGED THE NS HUMIDIFIER THREE TIMES, AND CHANGED THE OXYGEN CONNECTOR TWICE AND IT STILL MADE LOUD NOISE. SWITCHED NEW TUBING TO THE OLD PEDIATRIC NASAL CANNULA O2 TUBING AND IT RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
11510 SUPER SOFT CANNULA, NASAL, OXYGEN CAT WESTMED, INC. * 01172012T42

Patients

Seq Age Sex Outcome Treatment
1 6 MO