REUSABLE FLEXIBLE TUBING 622038

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2019-03-19 for REUSABLE FLEXIBLE TUBING 622038 manufactured by Respironics Inc..

Event Text Entries

[139229488] The manufacturer received information alleging ventilator circuit tubing "crushed in on itself. " at this time, it is not known if intervention was required. The manufacturer is currently investigating this event and a follow-up report will be filed when the investigation is complete.
Patient Sequence No: 1, Text Type: D, B5


[143722652] It was initially reported, the manufacturer received information alleging ventilator circuit tubing "crushed in on itself. " the tubing was returned to the manufacturer for evaluation. No deformities or material abnormalities were observed. The manufacturer concludes the tubing is within design specifications.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number2518422-2019-00624
MDR Report Key8433527
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2019-03-19
Date of Report2019-04-02
Date of Event2019-03-08
Date Mfgr Received2019-04-02
Date Added to Maude2019-03-19
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 ContactMR. ADAM PRICE
Manufacturer Street312 ALVIN DRIVE
Manufacturer CityNEW KENSINGTON PA 15668
Manufacturer CountryUS
Manufacturer Postal15668
Manufacturer G1RESPIRONICS INC.
Manufacturer Street1001 MURRY RIDGE LANE
Manufacturer CityMURRYSVILLE PA 15668
Manufacturer CountryUS
Manufacturer Postal Code15668
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameREUSABLE FLEXIBLE TUBING
Generic NameACCESSORY TO CONTINUOUS VENTILATOR (RESPIRATOR)
Product CodeMOD
Date Received2019-03-19
Model Number622038
Catalog Number622038
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerRESPIRONICS INC.
Manufacturer Address1001 MURRY RIDGE LANE MURRYSVILLE PA 15668 US 15668


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-03-19

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