inforMED
MalfunctionCAP

PORTEX HYPERINFLATION RESUSCITATION MANOMETERS

Received May 2, 2023

Report 3012307300-2023-04907 · MDR key 16857620

Device

Generic name

Monitor, Airway Pressure (includes Gauge And/or Al

Manufacturer

St Paul

Model number

008201

Catalog number

008201

Lot number

4132331

Product problems

  • Product Quality Problem
  • Product Quality Problem

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

OTHER TEXT: E4: CUSTOMER REPORTED TO FDA IS UNKNOWN. THIS REMEDIATION MDR WAS GENERATED UNDER PROTOCOL (B)(4), AS A RESULT OF WARNING LETTER CMS# (B)(4). NO PROBLEMS OR ISSUES WERE IDENTIFIED DURING THIS DEVICE HISTORY RECORD REVIEW. PICTURES WERE RECEIVED IN COMPLAINT INVESTIGATION, DURING REVIEW OF THE IMAGES INK STAINS INSIDE TUBE WERE 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.

Description of Event or Problem

IT WAS REPORTED THAT THERE WERE INK STAINS ON THE SURFACE. NO PATIENT INJURY WAS REPORTED.