inforMED
MalfunctionBYF

ADULT OXYGEN MASK WITH TUBING,02 DILUTER JETS (6),OXYGEN TUBE, NEBULIZER HOOD

Received Nov 5, 2015 · Event occurred Oct 22, 2014

Report 9680866-2015-31375 · MDR key 5204466

Device

Generic name

Mask, Oxygen, Low Concentration, Venturi

Model number

I002610

Product problems

  • Air Leak

Patient

Not reported

  • No Patient Involvement

Narrative

Additional Manufacturer Narrative

CONVATEC IS SUBMITTING THIS REPORT AS A RESULT OF ACTIVITIES RELATED TO CONVATEC REMEDIATION PROTOCOL (B)(4). CONVATEC IS SUBMITTING THIS REPORT PURSUANT TO THE PROVISIONS OF 21 CFR PART 803. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT WILL BE FILED ON A SUPPLEMENTAL REPORT (MEDWATCH 3500A).

Description of Event or Problem

CUSTOMER REPORTED THAT THE WHISTLE SOUND WAS HEARD FROM THE CONNECTION BETWEEN THE OXYGEN AND THE FLOWMETER, SO THE DEVICE WAS CHANGED TO THE NEW ONE.