inforMED
MalfunctionKDP

PUSH TO SET INTERMITTENT SUCTION REGULATOR

Received May 31, 2016 · Event occurred Mar 27, 2015

Report 1419185-2016-00005 · MDR key 5690258

Device

Generic name

Pts Isu

Manufacturer

Ohio Medical

Model number

1251

Catalog number

8707-1251-905

Lot number

ISU087151

Product problems

  • Appropriate Device Problem Term/Code Not Available

Patient

Not reported

  • No Patient Involvement
  • No Patient Involvement

Narrative

Description of Event or Problem

A USER FACILITY REPORTED TO US THAT THE DEVICE "HAS INTERNAL CAP ISSUES" ON (B)(6) 2015. THERE WAS NO PATIENT INVOLVEMENT, AND THE INCIDENT DID NOT RESULT IN A DELAY OF TREATMENT. THE DEVICE WAS EVALUATED ON 03/27/2015 AND IT WAS NOTED THAT THE DEVICE HAD A DAMAGED DIAPHRAGM. OUR RISK DOCUMENT CLASSIFIES THE SEVERITY OF A DAMAGED DIAPHRAGM AS "POTENTIALLY REQUIRING MEDICAL INTERVENTION TO PREVENT PERMANENT IMPAIRMENT OF A BODY FUNCTION OR PERMANENT DAMAGE TO A BODY STRUCTURE". WE ARE OBTAINING FURTHER CLINICAL EVALUATION OF THE RISK OF THIS FAILURE AND WILL PROVIDE FOLLOW UP TO THIS REPORT ONCE OBTAINED.

Additional Manufacturer Narrative

CLINICAL ASSESSMENT OF THE FAILURE MODE "DAMAGED DIAPHRAGM" HAS BEEN OBTAINED AND IT HAS BEEN DETERMINED THAT THIS OCCURRENCE DOES NOT REPRESENT A REPORTABLE MALFUNCTION DUE TO NO EVIDENCE EXISTING TO REASONABLY SUGGEST THAT THE MALFUNCTION WOULD BE LIKELY TO CAUSE OR CONTRIBUTE TO DEATH OR SERIOUS INJURY IF IT WERE TO RECUR. (B)(4).

Description of Event or Problem

CLINICAL ASSESSMENT OF THE FAILURE MODE "DAMAGED DIAPHRAGM" HAS BEEN OBTAINED AND IT HAS BEEN DETERMINED THAT THIS OCCURRENCE DOES NOT REPRESENT A REPORTABLE MALFUNCTION DUE TO NO EVIDENCE EXISTING TO REASONABLY SUGGEST THAT THE MALFUNCTION WOULD BE LIKELY TO CAUSE OR CONTRIBUTE TO DEATH OR SERIOUS INJURY IF IT WERE TO RECUR.

Remedial action

  • Repair