MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-26 for BREATH SYST 10MM HME MR 3M DISP 6694145 manufactured by Maquet Critical Care Ab.
[185018250]
When attempting to connect the patient to the ventilator, it was found the tubing was malfunctioning and was coming apart.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9882678 |
| MDR Report Key | 9882678 |
| Date Received | 2020-03-26 |
| Date of Report | 2020-01-31 |
| Date of Event | 2020-01-29 |
| Report Date | 2020-01-31 |
| Date Reported to FDA | 2020-01-31 |
| Date Reported to Mfgr | 2020-03-26 |
| Date Added to Maude | 2020-03-26 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| 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 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BREATH SYST 10MM HME MR 3M DISP |
| Generic Name | SET, TUBING AND SUPPORT, VENTILATOR (W HARNESS) |
| Product Code | BZO |
| Date Received | 2020-03-26 |
| Model Number | 6694145 |
| Lot Number | 181107 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MAQUET CRITICAL CARE AB |
| Manufacturer Address | 45 BARBOUR POND DRIVE WAYNE NJ 07470 US 07470 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-26 |