inforMED
MalfunctionCAP

PORTEX

Received Aug 4, 2021

Report 3012307300-2021-08066 · MDR key 12277282

Device

Generic name

Airway Pressure Monitor

Manufacturer

St Paul

Model number

008201

Lot number

4079322

Product problems

  • Product Quality Problem
  • Product Quality Problem

Patient

Unknown

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

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THERE WERE INK STAINS ON THE DEVICES.

Additional Manufacturer Narrative

OTHER, OTHER TEXT: ADDITIONAL INFORMATION ADDED TO H6 AND H10. THIS REMEDIATION MDR WAS GENERATED UNDER PROTOCOL B10010116, AS A RESULT OF WARNING LETTER CMS# 617147. NO PROBLEMS OR ISSUES WERE IDENTIFIED DURING THIS DEVICE HISTORY RECORD REVIEW. A PRODUCT SAMPLE WAS RECEIVED FOR EVALUATION. VISUAL AND FUNCTIONAL TESTING WERE PERFORMED. BASED ON PICTURES PROVIDED IN COMPLAINT INVESTIGATION, AFTER IMAGES REVIEW INK STAINS INSIDE TUBE CAN BE OBSERVED. THE ROOT CAUSE OF THE REPORTED ISSUE WAS FOUND TO BE OPERATOR MISHANDLING USING PRODUCTION EQUIPMENT. ACTIONS WERE TAKEN TO MITIGATE THE REPORTED ISSUE: A NOTIFICATION AWARENESS TO OPERATORS WERE ISSUED IN ORDER TO NOTIFY ALL PERSONNEL ABOUT ISSUE REPORTED WITH INK STAINS ON MANOMETER SURFACE.