FDA Adverse Event Malfunction Summary report: N

SERVO-U

MDR report key: 8168887 · Received December 17, 2018

Report

Report Number
8010042-2018-00673
Event Type
Malfunction
Date Received
December 17, 2018
Date of Event
December 11, 2018
Report Date
March 28, 2019
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K151814
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
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 (B)(4). CONTACT PERSON: (B)(4). 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. THE REPORTED FAILURE MODE WAS CONFIRMED IN THE RECEIVED DEVICE LOGS. 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.

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

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

Description of Event or Problem · 0

IT WAS REPORTED THAT THE VENTILATOR GENERATED A TECHNICAL ERROR CODE INDICATING SAFETY VALVE OPEN. THERE WAS NO PATIENT INVOLVEMENT. MANUFACTURER REF. #: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1010544 SERVO-U VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1