FDA Adverse Event Injury Summary report: N

LTV PATIENT CIRCUIT

MDR report key: 3803267 · Received May 9, 2014

Report

Report Number
2031702-2014-00122
Event Type
Injury
Date Received
May 9, 2014
Report Date
August 22, 2014
Manufacturer
CAREFUSION 203, INC
Product Code
CAI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
HI, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PEEP VALVE ON PATIENT CIRCUIT WAS STUCK OPEN AND WAS NOT GIVING ANY AIR TO PATIENT. THE PATIENT WAS IN DISTRESS AND WAS MANUALLY VENTILATED. THE LOW PRESSURE ALARM SETTINGS WERE TOO LOW AND THE ALARM VOLUME WAS TURNED DOWN. NO ALARM WAS DETECTED BECAUSE OF THE VENTILATOR ALARM SETTINGS. NO PATIENT HARM REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
281647 LTV PATIENT CIRCUIT CIRCUIT, BREATHING CAI CAREFUSION 203, INC 11558X10

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening| R