FDA Adverse Event Malfunction Summary report: N

SERVO-U

MDR report key: 7897889 · Received September 21, 2018

Report

Report Number
8010042-2018-00496
Event Type
Malfunction
Date Received
September 21, 2018
Report Date
November 9, 2018
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K151814
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

NO VENTILATOR LOGS WERE PROVIDED AND NO PARTS WERE RETURNED FOR INVESTIGATION. NO FURTHER INFORMATION WAS PROVIDED BY THE USER FACILITY REGARDING THE USE OF HIGH FREQUENCY JET VENTILATOR (HFJV) IN TANDEM WITH THE VENTILATOR. THE REPORTED TANDEM USE OF A HFJV IMPLIES THAT THE HFJV IS CONNECTED TO AN ET TUBE ADAPTER AND IT INDUCES A ¿JET¿ OF GAS OUT OF THE ADAPTER INTO THE AIRWAY. THE MEASURED INSPIRATORY VALUES WOULD BE AS PER THE SET PARAMETER VALUES BUT THE MEASURED EXPIRATORY VALUES WOULD INCLUDE THE VALUES OF THE HFJV AND THEREFORE, THE MEASURED EXPIRATORY VALUES WOULD NOT REFLECT THE PARAMETER SETTINGS AND WILL LEAD TO GENERATION OF APPROPRIATE ALARMS, FOR EXAMPLE FOR HIGH O2 CONCENTRATION. THE USE OF A HFJV IN TANDEM WITH THE VENTILATOR HAS NOT BEEN TESTED, APPROVED, OR RECOMMENDED FOR USE WITH THIS VENTILATOR SYSTEM. THEREFORE THE CONSEQUENCES OF ITS USE WITH OUR VENTILATOR ARE UNKNOWN. AS NO LOG FILES WERE PROVIDED AND NO PARTS WERE REPLACED AND RETURNED FOR OUR INVESTIGATION, IT HAS NOT BEEN POSSIBLE TO DETERMINE THE ROOT CAUSE OF THE REPORTED EVENT BUT THE USE OF HFJV IN TANDEM WITH THE VENTILATOR IS THE MOST LIKELY CONTRIBUTING FACTOR.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

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

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

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING VENTILATION, ALARMS FOR HIGH O2 CONCENTRATION WERE GENERATED WHEN THE VENTILATOR WAS USED IN TANDEM WITH A HIGH FREQUENCY JET VENTILATOR (HFJV). THERE WAS NO PATIENT HARM. IMPORTER REF. #: (B)(4). MANUFACTURER REF. #: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
739992 SERVO-U VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1