MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor,foreign,user faci report with the FDA on 2020-03-20 for NON-VENTED HOSPITAL FULL FACE MASK RT046 manufactured by Fisher & Paykel Healthcare Ltd.
        [187409960]
(b)(4). We are currently in the process of investigation. We will provide a follow up report upon completion of investigation.
 Patient Sequence No: 1, Text Type: N, H10
        [187409961]
A distributor reported on behalf of a heatlhcare facility in (b)(6) that the headgear strap of rt046 non-vented hospital full face masks were torn during use. There were no reported patient consequences.
 Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9611451-2020-00300 | 
| MDR Report Key | 9863025 | 
| Report Source | DISTRIBUTOR,FOREIGN,USER FACI | 
| Date Received | 2020-03-20 | 
| Date of Report | 2020-02-21 | 
| Date of Event | 2019-12-03 | 
| Date Mfgr Received | 2020-02-21 | 
| Date Added to Maude | 2020-03-20 | 
| 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 TECHOLOGY DR. 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 | NON-VENTED HOSPITAL FULL FACE MASK | 
| Generic Name | MNT | 
| Product Code | MNT | 
| Date Received | 2020-03-20 | 
| Model Number | RT046 | 
| Catalog Number | RT046 | 
| Lot Number | NOT PROVIDED | 
| Operator | HEALTH PROFESSIONAL | 
| Device Availability | N | 
| Device Eval'ed by Mfgr | R | 
| 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 | 2020-03-20 |