GCE COMBILITE I VIPRS, 5 MICRON FILTER, LIV FOR OXYGEN 0710204

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05 report with the FDA on 2010-09-17 for GCE COMBILITE I VIPRS, 5 MICRON FILTER, LIV FOR OXYGEN 0710204 manufactured by Linde Gas North America Llc.

Event Text Entries

[21758357] This report concerns the third out of three individuals injured in the present incident. Other cases for the same incident are: (b)(4). On (b)(6) 2008, an ambulance in (b)(6) was sent to an emergency situation, as a person had jumped out of a window. The person was still alive when the ambulance arrived at the scene and one of the paramedics wanted to give medicinal oxygen treatment (normal procedure) to the pt. When the paramedic opened the main valve of the conoxia 2 liter liv cylinder, a loud bang was heard and an oxygen flame came out of the conoxia cylinder. The oxygen flame went through the three layers of cloths that the paramedic was wearing and resulted in burn wounds to his breast (size of a handball) and arm. Two policemen that were at the scene were also slightly injured (injuries unk). The paramedic threw away the cylinder after the incident and was taken, together with the pt, to the nearest hospital (around 5 minutes from the scene). The paramedic was treated in the hosp for his burn wounds (mainly 1st, but also 2nd degree) and could return to his home later that night. All the injured persons could leave the hosp after nursing at the first aid department.
Patient Sequence No: 1, Text Type: D, B5


[21895696] The present case is one out of 9 incident reports in connection with 7 liv ignitions. Eval summary: root cause analysis summary - the cause of ignition with highest probability is ignition of hydrocarbons, lubricant, and/or debris by adiabatic compression. Potential sources of hydrocarbons and lubricants; lubricant (fomblin) migration (lubricant from gce mfg of valve), leaching of contaminants (phthalates) from o-rings in valves (lubricant in solvent) and hydrocarbon oil, leaching of contaminants (phthalates) from fill connector at filling plant at (b)(4). Potential sources of debris - debris from mfg process of valve at gce, debris from filling plant at (b)(4), debris from wear, valves in use. The design (filter and location of components in the high pressure side of the valve) of the gce liv valve 5 micron filter is likely to cause more sensitivity to adiabatic compression heating than the gce oxygen design.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3003900188-2010-00038
MDR Report Key2805402
Report Source01,05
Date Received2010-09-17
Date of Event2008-08-01
Date Mfgr Received2008-08-02
Device Manufacturer Date2007-05-01
Date Added to Maude2012-10-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location0
Manufacturer Street575 MOUNTAIN AVE
Manufacturer CityMURRAY HILL NJ 07974
Manufacturer CountryUS
Manufacturer Postal07974
Single Use3
Remedial ActionRC
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGCE COMBILITE I VIPRS, 5 MICRON FILTER, LIV FOR OXYGEN
Generic NameNONE
Product CodeECX
Date Received2010-09-17
Model Number0710204
Lot Number2551116
Device Expiration Date2017-05-22
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLINDE GAS NORTH AMERICA LLC
Manufacturer AddressMURRAY HILL NJ 07974 US 07974


Patients

Patient NumberTreatmentOutcomeDate
10 2010-09-17

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