FDA Adverse Event Malfunction Summary report: N

SERVO-U

MDR report key: 7671149 · Received July 9, 2018

Report

Report Number
8010042-2018-00343
Event Type
Malfunction
Date Received
July 9, 2018
Date of Event
June 16, 2018
Report Date
October 29, 2018
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K151814
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 0

GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF MAQUET CRITICAL CARE AB (MANUFACTURER). REF. EXEMPTION #: E2018003. GETINGE USA SALES, LLC 45 BARBOUR POND DRIVE WAYNE, NJ 07470. CONTACT PERSON: (B)(4).

Additional Manufacturer Narrative · 0

INVESTIGATION OF THE RETURNED EXPIRATORY PRINTED CIRCUIT (PC) BOARD HAS BEEN COMPLETED. THIS BOARD CONTAINS ELECTRONICS WHICH INCLUDE MICROPROCESSOR FOR CONTROL OF THE SAFETY VALVE FUNCTIONS IN THE INSPIRATORY SECTION OF THE DEVICE. ELECTRICAL MEASUREMENTS ON THE EXPIRATORY CHANNEL PC BOARD SHOWED THAT A CAPACITOR IN THE PULL MAGNET SUPPLY CIRCUIT WAS SHORTED, WHICH CAUSED THE SAFETY VALVE TO ALWAYS BE IN OPEN STATE. A FAILURE IN THE PULL MAGNET SUPPLY CIRCUIT CAN LEAD TO STOP OF VENTILATION IF THE SAFETY VALE IS NOT IN ITS PREDETERMINED STATE. APPEARANCE OF THIS FAILURE WILL BE NOTIFIED TO THE USER BY GENERATED HIGH PRIORITY ALARMS AND A TECHNICAL ERROR CODE. IF THE FAULT IS PRESENT IT WILL BE DETECTED DURING PRE-USE CHECK. THE CONCLUSION IN THIS MATTER IS THAT THE REPORTED ISSUE WAS CAUSED BY A SHORTED CAPACITOR ON THE EXPIRATORY CHANNEL PC BOARD, THAT IS PART OF THE SAFETY VALVE FUNCTION. GETINGE USA SALES, LLC (IMPORTER) IS SUBMITTING THIS REPORT ON BEHALF OF MAQUET CRITICAL CARE AB (MANUFACTURER). REF. EXEMPTION #: E2018003. GETINGE USA SALES, LLC 45 BARBOUR POND DRIVE WAYNE, NJ 07470. CONTACT PERSON: (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE VENTILATOR FAILED THE SAFETY VALVE TEST DURING PRE-USE CHECK. THERE WAS NO PATIENT INVOLVEMENT. MANUFACTURER REF #:(B)(4).

Description of Event or Problem · 0

(B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
510930 SERVO-U VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1