inforMED
MalfunctionIOY

SUPPORT ARM 179

Received Jul 21, 2020 · Event occurred Jul 17, 2020

Report 8010042-2020-00457 · MDR key 10301814

Device

Generic name

Support, Arm

Model number

SUPPORT ARM 179

Catalog number

6882001

Product problems

  • Detachment of Device or Device Component
  • Detachment of Device or Device Component

Patient

Prefer Not To Disclose

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

PROVIDED PICTURE SHOWED THAT THE METAL FASTENING MECHANISM ON THE RAIL CLAMP MOUNTED ON THE SUPPORT ARM HAD FALLEN OFF. THE SUPPORT ARM WILL BE REPLACED. THE ROOT CAUSE OF THE REPORTED ISSUE HAS NOT BEEN DETERMINED.

Description of Event or Problem

IT WAS REPORTED THAT THE SUPPORT ARM FOR PATIENT TUBING MOUNTED ON THE VENTILATOR BROKE. THERE WAS NO PATIENT HARM. MANUFACTURER'S REF #: (B)(4).

Description of Event or Problem

MANUFACTURER'S REF #: (B)(4).

Additional Manufacturer Narrative

THE SUPPORT ARM WAS RETURNED FOR INVESTIGATION. THE FIXATION PLATE ON THE RAIL CLAMP THAT IS USED FOR FIXATING THE SUPPORT ARM ON THE VENTILATOR¿S SIDE RAIL WAS MISSING AND THE FIXATION SCREW WAS BROKEN OFF. THE ROOT CAUSE OF THE BROKEN SUPPORT ARM HAS NOT BEEN CONCLUSIVELY DETERMINED BUT MOST LIKELY HAS IT BEEN EXPOSED TO A MECHANICAL FORCE GREATER THAN IT IS DESIGNED TO SUSTAIN.