MAUDE Adverse Event Report: RESMED LTD AIRFIT F30 MED SYS - AMER

Model Number 64101

Device Problem Component Missing (2306)

Patient Problem Dyspnea (1816)

Event Date 12/07/2020

Event Type  malfunction  

Manufacturer Narrative

Resmed has requested for the device to be returned so that an engineering investigation could be performed.The device has not been returned, therefore, resmed is unable to confirm the alleged malfunction at this time.Resmed reference#: (b)(4).

Event Description

It was reported to resmed that a patient using an airfit f30i mask could not exhale.The patient stated the product does not have exhale ports on the elbow of the mask.There was no patient harm or serious injury reported as a result of this incident.

Manufacturer Narrative

Resmed has requested for the device to be returned so that an engineering investigation can be performed.The device has not been returned, therefore, resmed is unable to confirm the alleged malfunction at this time.Resmed reference#: (b)(4).

Event Description

It was reported to resmed that a patient using an airfit f30 mask could not exhale.The patient stated the product does not have exhale ports on the elbow of the mask.There was no patient harm or serious injury reported as a result of this incident.

• Brand Name: AIRFIT F30 MED SYS - AMER
• Manufacturer (Section D): RESMED LTD; 1 elizabeth macarthur drive; bella vista; sydney, nsw 2153 ; AS 2153
• Manufacturer (Section G): RESMED LTD; 1 elizabeth macarthur drive; bella vista; sydney, nsw 2153 ; AS 2153
• Manufacturer Contact: michelle hughes ; 1 elizabeth macarthur drive; bella vista; sydney, nsw 2153 ; AS 2153
• MDR Report Key: 11090903
• MDR Text Key: 225121651
• Report Number: 3004604967-2020-01281
• Device Sequence Number: 1
• Product Code: BZD
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K183512
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date: 06/20/2022

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Model Number: 64101
• Device Catalogue Number: 64101
• Device Lot Number: 1453511
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Distributor Facility Aware Date: 06/13/2022
• Initial Date Manufacturer Received: 12/07/2020
• Initial Date FDA Received: 12/29/2020
• Supplement Dates Manufacturer Received: 06/13/2022
• Supplement Dates FDA Received: 06/20/2022
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: A
• Patient Sequence Number: 1