FDA Adverse Event Other Summary report: N

HUMIDIFIER 500 ML STERILE WATER

MDR report key: 360921 · Received November 16, 2001

Report

Report Number
1419377-2001-00003
Event Type
Other
Date Received
November 16, 2001
Report Date
November 16, 2001
Manufacturer
AUTOMATIC LIQUID PACKAGING, INC.
Product Code
BTT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

WHEN TAB IS TORN OFF INLET PORT NUMBER OF HUMIDIFIER BOTTLE IT DOES NOT ALWAYS PRODUCE A HOLE THAT IS CIRCULAR BUT RATHER OVAL IN SHAPE CAUSING O2 TO LEAK AT THE FITTING CONNECTION. INFANTS USE LOW FLOW AMOUNTS (1/32 TO 1/4 LPM) AND MAY CAUSE DESATURATION, HOWEVER, MONITOR HOOK-UP IS BACK UP AND DIRECTIONS FOR USE OF THIS UNIT SHOULD BE READ AND ADMINISTERED CORRECTLY, POSSIBLY CAUSING THE OPENING TEAR INSTEAD OF "SNAP OFF" AS DIRECTIONS STATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
52000 HUMIDIFIER 500 ML STERILE WATER HUMIDIFIER BOTTLE BTT AUTOMATIC LIQUID PACKAGING, INC. 2620 1E060

Patients

Seq Age Sex Outcome Treatment
1 NA Hospitalization