FDA Adverse Event Malfunction Summary report: N

NEO TEE INFANT T-PIECE RESUSCITATOR

MDR report key: 3232380 · Received July 12, 2013

Report

Report Number
3232380
Event Type
Malfunction
Date Received
July 12, 2013
Date of Event
March 4, 2013
Report Date
July 12, 2013
Manufacturer
MERCURY MEDICAL
Product Code
BTL
Product Problem
Yes
Report Source
User Facility report
Reporter Location
UT, US

Narratives

Description of Event or Problem · 1

THIS SPRING, INFANT IN NURSERY STARTING HAVING RESPIRATORY PROBLEMS AND WAS IN NEED OF IMMEDIATE RESUSCITATION. NURSE GRABBED THE NEO TEE DEVICE WHICH IS A SINGLE USE DEVICE. SHE OPENED THE PACKAGE AND APPLIED DEVICE TO BABY. THE DEVICE WOULD NOT FUNCTION. A NEW PACKAGE WAS OPENED AND BABY WAS RESUSCITATED. PRODUCT FAILURE DID DELAY EFFECTIVE RESUSCITATION HOWEVER; NO HARM CAME TO THE BABY. THE MALFUNCTIONING DEVICE WAS THEN INSPECTED. IT WAS FOUND THAT THE MANOMETER MECHANISM WAS NOT ALIGNED PROPERLY. THIS CAME OUT OF THE PACKAGE THAT WAY. IF THE NIPPLE ON THE MANOMETER IS NOT MATED IN THE HOLE AND BODY OF THE RESUSCITATOR PROPERLY, OXYGEN WILL FREE FLOW AND THE RESUSCITATOR WILL NOT WORK PROPERLY. IT WAS REPORTED THAT AFTER INSPECTION OF OTHER UNOPENED UNITS ONE MORE PROBLEM DEVICE WAS FOUND. THIS WAS REPORTED TO THE MANUFACTURER AT THE TIME OF THE EVENT. HOWEVER THIS WAS NOT REPORTED TO OUR RISK OR CLINICAL ENGINEERING DEPARTMENT UNTIL RECENTLY. THEREFORE, WE DO NOT HAVE A LOT NUMBER TO REPORT. AFTER AN INVESTIGATION WAS COMPLETED BY CLINICAL ENGINEERING IT WAS DISCOVERED THE MANUFACTURER HAS NOT RESPONDED BACK TO OUR FACILITY AT THIS TIME.WHAT WAS THE ORIGINAL INTENDED PROCEDURE?NA.DEVICE #1IS THIS A LABORATORY DEVICE OR LABORATORY TEST?NO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
322392 NEO TEE INFANT T-PIECE RESUSCITATOR VENTILATOR, EMERGENCY, POWERED (RESUSCITATOR) BTL MERCURY MEDICAL * UNK

Patients

Seq Age Sex Outcome Treatment
1 2 DAY