FDA Adverse Event Malfunction Summary report: N

SERVO-U

MDR report key: 8322212 · Received February 8, 2019

Report

Report Number
8010042-2019-00077
Event Type
Malfunction
Date Received
February 8, 2019
Date of Event
January 20, 2019
Report Date
April 15, 2019
Manufacturer
MAQUET CRITICAL CARE AB
Product Code
CBK
PMA / PMN Number
K151814
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
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 PERON: (B)(6). THE VENTILATOR WAS INVESTIGATED ON SITE BY OUR FIELD SERVICE ENGINEER (FSE). NO FAULT WAS FOUND WITH THE VENTILATOR, ALL TESTS PASSED AND NO PARTS WERE REPLACED. OUR FSE FOUND THAT A FILTER WAS USED ON THE INSPIRATORY SIDE. WHEN THE INSPIRATORY FILTER WAS REMOVED, THE ISSUE WITH THE 1-3 CMH2O PRESSURE SPIKES AT THE END OF INSPIRATION DISAPPEARED. THE FILTER WAS NOT MANUFACTURED OR DISTRIBUTED BY US. THE 1-3 CMH2O PRESSURE SPIKES WERE NOT RELATED TO LEAKAGE AS WAS REPORTED INITIALLY. EVALUATION OF THE RECEIVED DEVICE LOGS SHOW THAT PRE-USE CHECK PRIOR TO AND AFTER THE EVENT WAS SUCCESSFULLY. THERE IS NO ENTRY IN THE TECHNICAL LOG TO INDICATE A TECHNICAL FAILURE IN THE VENTILATOR. AFTER THE USER HAD REMOVED THE FILTER FROM THE INSPIRATORY SIDE NO FURTHER ISSUES HAVE BEEN REPORTED AND THE VENTILATOR HAS BEEN RETURNED BACK INTO CLINICAL USE.

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 PERON: (B)(4).

Description of Event or Problem · 0

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

Description of Event or Problem · 0

IT WAS REPORTED THAT WHILE THE VENTILATOR WAS CONNECTED TO A PATIENT, THERE WERE PRESSURE SPIKES LEADING TO PEAK PRESSURES RISES OF 1-3 CMH2O WHEN LEAKAGE WAS PRESENT. THE SPIKES DISAPPEARED ONCE LEAKAGE WAS CORRECTED. THERE WAS NO PATIENT HARM. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
112154 SERVO-U VENTILATOR, CONTINUOUS, FACILITY USE CBK MAQUET CRITICAL CARE AB

Patients

Seq Age Sex Outcome Treatment
1