AMARA VIEW C PAP MASK SIZE LARGE 1090624

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-20 for AMARA VIEW C PAP MASK SIZE LARGE 1090624 manufactured by Philips Respironics.

Event Text Entries

[78296794] I received a cpap amara view mask from (b)(6) on (b)(6). When trying to wear the mask at home, i noticed that the mask cushion was marked as size large (as was the mask packaging) but the actual cushion was size smaller than large (guessing medium). I have been wearing this mask for a while so i know how the large mask cushion feels and fits and knew right away that this cushion was too small. I further compared it to a large mask cushion that i had from an older mask and immediately could see the size difference. I contacted philips respironics and they said that they could note this and there was nothing else they could do. I contacted the sleep center who overnighted me a replacement large amara view mask size large as i am on vacation and this was the only mask that i had brought with me... The large mask cushion that i had used for comparison of size was well over 30 days old and did not have 10 days of use available for the duration of my vacation. The mask that the sleep center sent me was from the same lot and reference number as the subject original mask and it was also found to have the smaller improperly labeled mask cushion. I once again took pictures and contacted philips respironics about the issue. This issue caused me to have to cash pay to order a large replacement cushion and have it expedited to me on vacation to get through my time away. I don't presently have a dme provider as i am in between providers which is why i had to have the repeat sleep study. So my only option was to cash pay to get a cushion so that i could use the mask. The cushion i cash paid was made and labeled properly and i was able to wear it with no problem. I provided additional pictures to philips respironics after receiving the replacement cushion. Having spent most of my working career in the pharmaceutical/medical device industry, i know that this is a critical issue, and wanted to properly report it to fda as well. Mask is lot 61478581, reference number (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5070558
MDR Report Key6659909
Date Received2017-06-20
Date of Report2017-06-20
Date of Event2017-06-16
Date Added to Maude2017-06-22
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NameAMARA VIEW C PAP MASK SIZE LARGE
Generic NameAMARA VIEW C PAP MASK SIZE LARGE
Product CodeBTK
Date Received2017-06-20
Model Number1090624
Lot Number61478581
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerPHILIPS RESPIRONICS

Device Sequence Number: 2

Brand NameAMARA VIEW C PAP MASK SIZE LARGE
Generic NameAMARA VIEW C PAP MASK SIZE LARGE
Product CodeBTK
Date Received2017-06-20
Model Number1090624
Lot Number61478581
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerPHILIPS RESPIRONICS


Patients

Patient NumberTreatmentOutcomeDate
10 2017-06-20

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