MEDISORB M11173310

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-03-01 for MEDISORB M11173310 manufactured by Vyaire Medical, Inc..

Event Text Entries

[101264441]
Patient Sequence No: 1, Text Type: N, H10


[101264442] When setting up for an operating room case, anesthesia found a crack in the plastic housing underneath the orange protective cover of a new co2 multi-absorber. The device was not use on the patient. Per manufacturer response to the hospital. (b)(4) has sold this division to vyaire.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number7305736
MDR Report Key7305736
Date Received2018-03-01
Date of Report2018-02-22
Date of Event2018-02-08
Report Date2018-02-22
Date Reported to FDA2018-02-22
Date Reported to Mfgr2018-02-22
Date Added to Maude2018-03-01
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMEDISORB
Generic NameABSORBENT, CARBON-DIOXIDE
Product CodeCBL
Date Received2018-03-01
Catalog NumberM11173310
Lot Number171104-0101
Device Expiration Date2019-11-18
Device AvailabilityY
Device Age1 DY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerVYAIRE MEDICAL, INC.
Manufacturer Address26125 N. RIVERWOODS BLVD METTAWA IL 60045 US 60045


Patients

Patient NumberTreatmentOutcomeDate
10 2018-03-01

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