FDA Adverse Event Malfunction Summary report: N

SURGICAL FREE FLOW VACUUM REGULATOR

MDR report key: 578229 · Received February 21, 2005

Report

Report Number
1121732-2005-00001
Event Type
Malfunction
Date Received
February 21, 2005
Date of Event
January 19, 2005
Report Date
February 18, 2005
Manufacturer
OHMEDA MEDICAL
Product Code
GCX
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

CUSTOMER REPORTED A VACUUM REGULATOR EXPLODED WHEN THE VACUUM ADAPTER WAS INSERTED INTO THE VACUUM WALL OUTLET PRIOR TO A P[ROCEDURE ( NO PATIENT INVOLVEMENT). A NEW UNIT WAS CONNECTED TO THE SAME WALL VACUUM CONNECTOR. THE PROCEDURE WAS COMPLETED WITHOUT ANY FURTHER PROBLEMS NOTED. THERE WAS NO REPORTED PATIENT INJURY. THE HOSPITAL'S TECHNICAL TEAM FURTHER REPORTED THE GAS OUTLET CONFIGURATION IN EACH ROOM WILL BE ASSESSED FOR STANDARDIZATION TO ENABLE EACH ROOM TO BE IDENTICAL. OHMEDA MEDICAL AGREED TO PROVIDE AN EDUCATIONAL MEMO FOR CIRCULATION TO HOSPITAL PERSONNES. THE MEMO WILL DISCUSS THE REPORTED EVENT, ITS CAUSES, AND PREVENTIVE ACTION. THERE ARE APPROXIMATELY 30,000 UNITS IN THE FIELD WITH NO PREVIOUS HISTORY OF SIMILAR CONDITIONS FROM OTHER HOSPITALS. INVESTIGATION CONCLUSION:SAMPLE WAS FORWARDED TO THE MANUFACTURING SITE FOR INVESTIGATION. THE SAMPLE WAS EVALUATED, AND IT APPEARS THE UNIT WAS SUBJECTED TO EXCESSIVE FORCE CENTERED ON THE ADJUSTMENT KNOB IN THE OUTWARD DIRECTION. EVIDENCE SUGGESTS THIS WAS DUE TO USER ERROR, I.E AS OPPOSED TO VACUUM, THE UNIT WAS SUBJECTED TO POSITIVE PRESSURE., RESULTING IN EXPANSION OF THE BELLOWS AND DAMAGE TO THE UNIT. THE VACUUM REGULATOR INSTRTUCTIONS FOR USE CONTAINS A WARNING "CONNECTION TO PRESSURE SOURCES, EVEN MOMENTARILY, COULD INJURE THE PATIENT OR OPERATOR AND DAMAGE THE EQUIPMENT." TO FURTHER OHMEDA MEDICAL'S INVESTIGATION, A SITE VISIT WAS MADE TO GATHER ADDITIONAL INFORMATION. INSPECTION OF THE FACILITY'S WALL OUTLETS INDICATED ALL CEILING COLUMNS DO NOT HAVE VACUUM OUTLETS, AND SOME OUTLETS ARE MISSING THE LABELLING ENDICATING THE GAS OR VACUUM TYPE. THE HOSPITAL'S TECHNICAL TEAM REPORTED THEY WILL PREPARE LABELS FOR THE OUTLETS TO IMPROVE VISIBILITY OF THE GAS TYPE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SURGICAL FREE FLOW VACUUM REGULATOR VACUUM REGULATOR GCX OHMEDA MEDICAL * NA

Patients

Seq Age Sex Outcome Treatment
1 *