inforMED
MalfunctionCBL

MEDISORB MULTI-ABSORBER ORIGINAL, DISPOSABLE

Received May 28, 2021 · Event occurred Apr 19, 2021

Report 3002807637-2021-00018 · MDR key 11904885

Device

Generic name

Absorbent, Carbon-dioxide

Manufacturer

Vyaire Medical

Catalog number

8003138

Lot number

0970120

Product problems

  • Leak/Splash
  • Leak/Splash

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

AT THIS TIME, THE SUSPECT DEVICE HAS NOT BEEN RETURNED FOR EVALUATION. BUT THE DHR (DEVICE HISTORY RECORD) AND PHOTO ANALYSIS HAS BEEN REQUESTED. HOWEVER, AT THIS TIME, NO ROOT CAUSE COULD BE DETERMINED YET. VYAIRE MEDICAL WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem

IT WAS REPORTED TO VYAIRE MEDICAL THAT THE LEAK WAS DETECTED ON 8003138 MEDISORB¿ MULTI-ABSORBER ORIGINAL, DISPOSABLE DURING SURGERY. THERE WAS NO HEALTH HAZARDS HAVE BEEN REPORTED TO PATIENTS AT THIS TIME.