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 2020-01-08 for OPTIFLOW JUNIOR INTERFACE OPT314 manufactured by Fisher & Paykel Healthcare Ltd.
[182343783]
(b)(4). The opt314 optiflow junior cannula was received at fisher & paykel healthcare in (b)(4) but evaluation has not yet begun. We are also in process to obtain further iformation from the customer to determine if f&p's product caused or contributed to the reported event. We will provide a follow up report upon completion of our investigation.
Patient Sequence No: 1, Text Type: N, H10
[182343784]
A healthcare facility in (b)(6) reported via a fisher & paykel healthcare (f&p) representative that the tube was broken from the connector of an opt314 optiflow junior nasal cannula during use. There was no patient consequences.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9611451-2020-00034 |
| MDR Report Key | 9567219 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-01-08 |
| Date of Report | 2019-12-10 |
| Date of Event | 2019-12-05 |
| Date Mfgr Received | 2020-02-24 |
| Date Added to Maude | 2020-01-08 |
| 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 |
| 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 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 | OPTIFLOW JUNIOR INTERFACE |
| Generic Name | CAT |
| Product Code | CAT |
| Date Received | 2020-01-08 |
| Returned To Mfg | 2020-01-09 |
| Model Number | OPT314 |
| Catalog Number | OPT314 |
| 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 | 2020-01-08 |