inforMED
MalfunctionBTM

PORTEX 1ST RESPONSE MANUAL RESUSCITATOR

Received Mar 1, 2023 · Event occurred Sep 23, 2022

Report 3012307300-2023-01824 · MDR key 16461321

Device

Generic name

Ventilator, Emergency, Manual (resuscitator)

Catalog number

8520BM

Lot number

181203

Product problems

  • Failure to Deliver
  • Failure to Deliver

Patient

Unknown

  • Low Oxygen Saturation
  • Decreased Respiratory Rate
  • Respiratory Insufficiency
  • Low Oxygen Saturation
  • Decreased Respiratory Rate
  • Respiratory Insufficiency

Narrative

Additional Manufacturer Narrative

UDI IS UNKNOWN, NO PRODUCT INFORMATION HAS BEEN PROVIDED TO DATE. EXPIRATION DATE AND MANUFACTURE DATE ARE UNKNOWN. NO INFORMATION IS AVAILABLE BASED ON REPORTED LOT NUMBER. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL REPORTABLE INFORMATION BECOMES AVAILABLE.

Description of Event or Problem

IT WAS REPORTED THAT A MEDICAL TEAM USED MATERIAL WITH THE CORRECT TECHNIQUE AND ADEQUATE FACE MASK SIZE, HOWEVER, THE VENTILATION MANEUVER WAS INADEQUATE, AS THE BAG DID NOT GENERATE ENOUGH PRESSURE AND THE CHILD'S CHEST DID NOT EXPAND AND DID NOT RECOVER SPO2.

Additional Manufacturer Narrative

NO PRODUCT SAMPLE WAS RECEIVED; THEREFORE, VISUAL AND FUNCTIONAL TESTING COULD NOT BE PERFORMED. A REVIEW OF MANUFACTURING DEVICE HISTORY RECORDS FOUND NO DISCREPANCIES OR ANOMALIES. THE REPORTED ISSUE COULD NOT BE CONFIRMED. IF THE PRODUCT IS RETURNED, THE MANUFACTURER WILL REOPEN THIS COMPLAINT FOR FURTHER INVESTIGATION. NO ACTIONS HAVE BEEN TAKEN AT THIS TIME.