FDA Adverse Event Injury Summary report: N

PRESSURE SAFE HIGH FLOW NASAL CANNULA

MDR report key: 8339476 · Received February 13, 2019

Report

Report Number
MW5084056
Event Type
Injury
Date Received
February 13, 2019
Report Date
February 12, 2019
Manufacturer
WESTMED, INC
Product Code
CAT
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

PRODUCT IS SUPPOSED TO BE DESIGNED TO POP-OFF AT PRESSURES BETWEEN 18-21 CMH2O. THE PRODUCT SHOULD THEN BE ABLE TO PREVENT BAROTRAUMA TO THE PATIENT AND THE PRESSURES AT THE POP-OFF SHOULD BE THE SAME AS WHAT IT IS AT THE NARES. INITIAL TESTING WAS CONDUCTED AND ALL PRESSURES WERE SUPPOSED TO BE EQUAL. UPON FURTHER EVALUATION IT WAS DETERMINED THAT AT FLOWS GREATER THAN 6LPM, THE PRODUCT IFU STATES IT CAN BE USED AT FLOWS FROM 5-10LPM; THE PRESSURE READING AT THE NARES WAS NOT CONSISTENT WITH THE MANUFACTURER CLAIMS. SECONDARY TESTING WAS CONDUCTED AND IT WAS FOUND THAT PRESSURES AT 6LPM AND HIGHER DID NOT HAVE THE SAME PRESSURE READING AT THE NARES AND POP-OFF. THE PRESSURES WERE SIGNIFICANTLY HIGHER AND COULD CAUSE TRAUMA TO THE PATIENT'S LUNGS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
127480 PRESSURE SAFE HIGH FLOW NASAL CANNULA CANNULA, NASAL, OXYGEN CAT WESTMED, INC 0882
127481 PRESSURE SAFE HIGH FLOW NASAL CANNULA CANNULA, NASAL, OXYGEN CAT WESTMED, INC 0885
127482 PRESSURE SAFE HIGH FLOW NASAL CANNULA CANNULA, NASAL, OXYGEN CAT WESTMED, INC 0886
127483 PRESSURE SAFE HIGH FLOW NASAL CANNULA CANNULA, NASAL, OXYGEN CAT WESTMED, INC 0887

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening| S