inforMED
MalfunctionBTM

AIRFLOW SMALL ADULT RESUSCITATOR

Received Apr 2, 2013

Report 2246980-2013-00003 · MDR key 3212895

Device

Generic name

Ventilator, Emergency, Manual (resus)

Manufacturer

Ventlab Llc

Model number

AF5040MB

Lot number

105181

Product problems

  • Deflation Problem
  • Disconnection

Patient

Not reported

  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

WHEN USING THE AMBU BAG ON A PT, IT WAS DISCOVERED THAT THE RESERVOIR BAG WAS DEFLATED AND UPON FURTHER INSPECTION IT WAS DETERMINED THE TUBING FROM THE OXYGEN SOURCE WAS NOT CONNECTED TO THE AMBU BAG.

Additional Manufacturer Narrative

METHOD/RESULTS: PRODUCT NOT RETURNED FOR EVAL. ENGINEERING PERFORMING TOLERANCE STACK-UP.