FDA Adverse Event Malfunction Summary report: N

ADULT BREATHING CIRCUIT DUAL HEATED

MDR report key: 864999 · Received June 15, 2007

Report

Report Number
9611451-2007-00213
Event Type
Malfunction
Date Received
June 15, 2007
Report Date
May 10, 2007
Manufacturer
FISHER & PAYKEL HEALTHCARE, LTD.
Product Code
BTT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS IS A MALFUNCTION THAT HAS BEEN REPORTED TO FISHER AND PAYKEL HEALTHCARE. THE PRODUCT IS NOT SOLD IN THE USA, BUT IT IS SIMILAR TO A PRODUCT WHICH IS SOLD IN THE USA. THE 510 (K) FOR THAT PRODUCT IS K903112. THE FAULTY PRODUCT WAS VISUALLY INSPECTED. ONE HEATER WIRE PIN ON THE EXPIRATORY SIDE WAS BENT, MAKING IT IMPOSSIBLE TO CONNECT THE ELECTRICAL ADAPTOR TO THE BREATHING CIRCUIT. IF THE PINS HAD BEEN BENT RIGHT OVER DURING MANUFACTURING, THEY WOULD HAVE BEEN DETECTED DURING OUR ELECTRICAL TESTS AND VISUAL INSPECTIONS. WE BELIEVE THAT THE BENDING OBSERVED OCCURRED WHEN THE HEATER WIRE ADAPTOR WAS BEING CONNECTED DURING BREATHING CIRCUIT SET-UP. THE DEVICE FAILED JUST PRIOR TO USE. THE RATE OF OCCURRENCE FOR SUCH COMPLAINTS IS APPROXIMATELY 0.0011 WORLDWIDE FOR THE LAST YEAR. THE FOLLOWING MDR NUMBER ARE RELATED: 9611451-2007-00013, 9611451-2007-00052, 9611451-2007-00195, 9611451-2007-00215, 9611451-2007-00017, 9611451-2007-00044, 9611451-2007-00202, 9611451-2007-00214. A BENT HEATER WIRE PIN THE HEATED BREATHING CIRCUIT UNUSABLE AS THE HEATER WIRE ADAPTER CANNOT BE CONNECTED. THIS WOULD BE IDENTIFIED AT SET UP.

Description of Event or Problem · 1

REPORTER REPORTED THAT THEY FOUND IT IMPOSSIBLE TO CONNECT THE ELECTRICAL ADAPTER TO THE RT204 BREATHING CIRCUIT BECAUSE THE PIN FOR THE HEATER WIRE WAS BENT (EXPIRATORY SIDE ).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADULT BREATHING CIRCUIT DUAL HEATED BTT FISHER & PAYKEL HEALTHCARE, LTD. RT204 060920

Patients

Seq Age Sex Outcome Treatment
1 YR