inforMED
MalfunctionBTM

MEDLINE

Received Mar 7, 2026 · Event occurred Jan 30, 2026

Report 1314417-2026-00011 · MDR key 24539797

Device

Generic name

Resuscitator, Small Adult, Bag Res, Peep, Mano

Manufacturer

Medline Industries

Model number

CPRM4416FPM

Catalog number

CPRM4416FPM

Lot number

555593, 581139

Product problems

  • Gas/Air Leak

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

H6: 4756 (APPROPRIATE IMPACT TERM/CODE NOT AVAILABLE): MANUAL RESUSCITATION BAG. THE COMPLAINT PRODUCT WAS RETURNED TO THE SUPPLIER FOR EVALUATION. FUNCTIONAL TESTING WAS PERFORMED ON THE RETURNED PRODUCT (LOT 555593). TEST RESULTS DEMONSTRATED THAT THE SAMPLED DEVICES MET THE REQUIREMENTS OF ISO 10651 4:2023 FOR OXYGEN DELIVERY AND MINIMUM TIDAL VOLUME. THE REPORTED ISSUE COULD NOT BE CONFIRMED. A REVIEW OF COMPLAINT HISTORY IDENTIFIED NO ADDITIONAL COMPLAINTS INVOLVING THE SAME PART NUMBER OR SIMILAR FAILURE MODES WITHIN THE PRECEDING 24 MONTHS. NO TRENDS WERE IDENTIFIED; ONGOING MONITORING WILL CONTINUE FOR ANY EMERGING TRENDS. THE DEVICE HISTORY RECORD FOR LOT 555593 WAS REVIEWED AND CONFIRMED THAT THE PRODUCT WAS MANUFACTURED IN ACCORDANCE WITH SPECIFICATIONS. ALL INFORMATION REASONABLY KNOWN AS OF 15 APR 2026 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AIRLIFE REPRESENTS ALL OF THE INFORMATION KNOWN AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT/REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AIRLIFE. AIRLIFE HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED, BUT IS RELAYING THE INFORMATION PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AIRLIFE COMPLAINT DATABASE AND IDENTIFIED AS (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21 CFR 803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT, AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AIRLIFE PRODUCT IS DEFECTIVE, CAUSED, OR CONTRIBUTED TO A SERIOUS INJURY.

Description of Event or Problem

IT WAS REPORTED THAT THE RESUSCITATION BAG WAS LEAKING AIR, WITH THE OXYGEN AREA INTERMITTENTLY POPPING OFF THE BACK, RESULTING IN INADEQUATE OXYGEN DELIVERY DURING RESUSCITATION.

Additional Manufacturer Narrative

H6: 4756 (APPROPRIATE IMPACT TERM/CODE NOT AVAILABLE): MANUAL RESUSCITATION BAG. THE PRODUCT INVOLVED IN THE REPORT HAS NOT BEEN RETURNED. A REVIEW OF THE DEVICE HISTORY RECORD IS IN-PROGRESS. ALL INFORMATION REASONABLY KNOWN AS OF 07 MAR 2026 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AIRLIFE REPRESENTS ALL OF THE INFORMATION KNOWN AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT/REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AIRLIFE. AIRLIFE HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED, BUT IS RELAYING THE INFORMATION PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AIRLIFE COMPLAINT DATABASE AND IDENTIFIED AS (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21 CFR 803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT, AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AIRLIFE PRODUCT IS DEFECTIVE, CAUSED, OR CONTRIBUTED TO A SERIOUS INJURY.

Description of Event or Problem

IT WAS REPORTED THAT THE RESUSCITATION BAG WAS LEAKING AIR, WITH THE OXYGEN AREA INTERMITTENTLY POPPING OFF THE BACK, RESULTING IN INADEQUATE OXYGEN DELIVERY DURING RESUSCITATION.