CIRCUIT, ADULT DUAL-LIMB, DUAL-HEAT AH280

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2017-11-27 for CIRCUIT, ADULT DUAL-LIMB, DUAL-HEAT AH280 manufactured by Vyaire Medical, Inc.

Event Text Entries

[92996239] Initial emdr submission: no sample is available. If any additional information becomes available a follow-up submission will be filed.
Patient Sequence No: 1, Text Type: N, H10


[92996240] Respiratory therapy has changed heated wire circuits for ventilators and the new circuits collect water and occlude the tubing the patient has to breathe through.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8030673-2017-00385
MDR Report Key7060991
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2017-11-27
Date of Report2018-02-23
Date of Event2017-11-10
Date Mfgr Received2018-02-02
Date Added to Maude2017-11-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMINDY FABER
Manufacturer Street26125 N RIVERWOODS BLVD
Manufacturer CityMETTAWA IL 60045
Manufacturer CountryUS
Manufacturer Postal60045
Manufacturer G1VYAIRE MEDICAL, INC
Manufacturer StreetCERRADA VIA DE LA PRODUCCION NO. 85 PARQUE INDUSTRIAL MEX
Manufacturer CityMEXICALI BAJA CALIFORNIA NORTE
Manufacturer CountryMX
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCIRCUIT, ADULT DUAL-LIMB, DUAL-HEAT
Generic NameOXYGEN ADMINISTRATION KIT
Product CodeOGL
Date Received2017-11-27
Catalog NumberAH280
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerVYAIRE MEDICAL, INC
Manufacturer Address26125 N RIVERWOODS BLVD METTAWA IL 60045 US 60045


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-11-27

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