MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2019-12-12 for NASAL INTERFACE OPT944 manufactured by Fisher & Paykel Healthcare Ltd.
[179782998]
(b)(4). The complaint opt944 nasal cannula (opt944) is not returning to fisher & paykel healthcare for evaluation. We are in the process of obtaining further information from the customer to determine if the opt944 caused or contributed to the reported event. We will provide a follow up report upon completion of the investigation
Patient Sequence No: 1, Text Type: N, H10
[179782999]
A healthcare facility in (b)(4) reported via fisher & paykel healthcare (f&p) field representative that the tubings of nasal cannula broke during use. It was also reported that epoprostenol was being delivered during the reported event. There was no patient consequences.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9611451-2019-01204 |
| MDR Report Key | 9463525 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2019-12-12 |
| Date of Report | 2019-11-14 |
| Date of Event | 2019-11-09 |
| Date Mfgr Received | 2020-02-28 |
| Date Added to Maude | 2019-12-12 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS FARANAK GOMAROONI |
| Manufacturer Street | 173 TECHNOLOGY DRIVE SUITE 100 |
| Manufacturer City | IRVINE CA 92618 |
| Manufacturer Country | US |
| Manufacturer Postal | 92618 |
| Manufacturer Phone | 9194534000 |
| Manufacturer G1 | FISHER & PAYKEL HEALTHCARE LTD |
| Manufacturer Street | 15 MAURICE PAYKEL PLACE EAST TAMAKI |
| Manufacturer City | AUCKLAND, 2013 |
| Manufacturer Country | NZ |
| Manufacturer Postal Code | 2013 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NASAL INTERFACE |
| Generic Name | CAT |
| Product Code | CAT |
| Date Received | 2019-12-12 |
| Returned To Mfg | 2020-01-08 |
| Model Number | OPT944 |
| Catalog Number | OPT944 |
| Lot Number | NOT PROVIDED |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | FISHER & PAYKEL HEALTHCARE LTD |
| Manufacturer Address | 15 MAURICE PAYKEL PLACE EAST TAMAKI AUCKLAND, 2013 NZ 2013 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-12-12 |