FDA Adverse Event Malfunction Summary report: N

8010042-2018-00436

MDR report key: 7804761 · Received August 22, 2018

Report

Report Number
8010042-2018-00436
Event Type
Malfunction
Date Received
August 22, 2018
Date of Event
July 20, 2018
Report Date
September 10, 2018
PMA / PMN Number
K123149
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

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

THE INVESTIGATION OF THE RETURNED EXPIRATORY CHANNEL 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. THE PC-BOARD WAS INSTALLED IN A REFERENCE SYSTEM FOR SIMULATED USE TESTING. THE PRE-USE CHECK FAILED THE INTERNAL LEAKAGE TEST SINCE THE SAFETY VALVE IS OPEN, WHEN IT WAS EXPECTED TO BE CLOSED. THE CONCLUSION OF THE INVESTIGATION IS THAT THE ISSUE OCCURRED, DUE TO A SHORT CIRCUIT IN A CAPACITOR THAT IS PART OF THE ELECTRONICS FOR SAFETY VALVE FUNCTION. THE ROOT CAUSE OF WHY THE CAPACITOR FAILED HAS NOT BEEN DETERMINED. THE DEVICE LOGS ARE CONFIRMING THE REPORTED EVENT. WE COULD TRACE BACK THE REPORTED PROBLEM TO JULY 20, THEREFORE THE DATE OF EVENT WAS DETERMINED AS 07/20/2018. 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 INTERNAL LEAKAGE TEST DURING PRE-USE CHECK. THERE WAS NO PATIENT INVOLVEMENT. (B)(4).

Description of Event or Problem · 0

IMPORTER REF. #: (B)(4). MANUFACTURER REF. #: (B)(4).

Patients

Seq Age Sex Outcome Treatment
1