RESUS, INF W/MASK, RESV BAG, P/O, 6/CS 2K8004

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-03-13 for RESUS, INF W/MASK, RESV BAG, P/O, 6/CS 2K8004 manufactured by Carefusion/bd.

Event Text Entries

[69841946] (b)(4) has reached out to customer three times to provide the complaint device for further investigation. A (b)(6) label was also provided to the customer each time. Unfortunately, (b)(4) has not received the complaint device for evaluation or the requested additional information. The end-user has not responded to email or phone messages. Analyst had been attempting to find out if this incident actually happened with this product code. The customer reported the exact same incident with a different product code. The sales rep stated "it is my understanding it was am adult bag which is why it wasn? T more of an issue for them". We are conservatively reporting this incident as we are unable to verify this information with the end-user. If the sample or any additional information becomes available a follow up emdr will be submitted. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[69841947] Customer reported that the hospital is having issues. Staff is saying that it all has to do with them not being able to detach the mask from the bag. This has happened a few times to us at (b)(6). It is random, and has not caused any patient problems. I assumed someone had pushed the mask too far on to the bag and i wasn't strong enough to get it apart. One tech said that he had trouble disconnecting the bag from the endotracheal tube, the end of the tube came apart when the bag was removed. Luckily there was a couple extra rt's there that fixed the issue very quickly.
Patient Sequence No: 1, Text Type: D, B5


[73137257] The following information should be removed from this report. "the staff is not able to detach the mask from the bag. ? This has happened a few times to us at (b)(6). It is random, and has not caused any patient problems. I assumed someone had pushed the mask too far on to the bag and i wasn't strong enough to get it apart". This information is reflected in a different complaint. Customer advocacy is still waiting for additional information regarding reported issue. If a sample or any additional information becomes available a follow up emdr will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[73596935] Follow up submission: no sample was provided for evaluation. At this time we are unable to confirm the reported issue. However, based on similar complaint investigations, a probable root cause is related to the current mirror finish surface on the elbow, which makes the mask very difficult to remove. Capa was opened to further investigate this issue. Capa (b)(4). The elbow will now contain a textured finish to allow the mask to be easily removed from the elbow.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number8030673-2017-00305
MDR Report Key6401182
Date Received2017-03-13
Date of Report2017-10-13
Date of Event2017-02-10
Date Mfgr Received2017-07-07
Date Added to Maude2017-03-13
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMINDY FABER
Manufacturer Street75 N. FAIRWAY DR.
Manufacturer CityVERNON HILLS IL 60061
Manufacturer CountryUS
Manufacturer Postal60061
Manufacturer G1CAREFUSION/BD
Manufacturer StreetCERRADA V NO.85 PARQUE INDUSTRIAL
Manufacturer CityMEXICALI BAJA CALIFORNIA NORTE
Manufacturer CountryMX
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameRESUS, INF W/MASK, RESV BAG, P/O, 6/CS
Generic NameMANUAL EMERGENCY VENTILATOR
Product CodeOEV
Date Received2017-03-13
Catalog Number2K8004
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerCAREFUSION/BD
Manufacturer AddressCERRADA V?A DE LA PRODUCCI?N NO.85 PARQUE INDUSTRIAL MEXICALI BAJA CALIFORNIA NORTE MX


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-03-13

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