(b)(4).Method: the three complaint op316 cannulae were received at fisher & paykel healthcare and were visually inspected.An additional 46 sealed, unused cannulae were received.The unused samples were visually inspected and submitted to tensile strength testing to check the retention of the tubing in the swivel grip.Results: visual inspection of the complaint cannulae revealed that in two cases one of the flexitubes had become disconnected from the swivel grip and the third cannula had both tubes detached from the swivel grip.Glue was present on the surfaces of both tubing and swivel grips.Visual inspection of the 46 unused cannulae showed that there was no visible damage or defect with any of them.All 46 were pull tested and the joint strength was found to be within specification, with no detaching of the tubing from the swivel grip.Conclusion: we were unable to determine what had caused the observed damage.However we were informed that the damage had occurred in each case while the infant was being held by a caregiver, so it is possible that excessive force was exerted on the tubing/swivel connection.All optiflow junior cannulae are 100% leak and occlusion tested after final assembly and any cannula that fails is discarded.In addition, samples are taken hourly from each run and pull tested to check glue joint strength at the cannula/tube joint, as well as the swivel grip joint.If there are any failures the entire batch is put aside for further investigation.The user instructions illustrate in pictorial format the correct set-up and proper use of the optiflow junior nasal cannula.They also state the following: - ensure that all connections are secure during use.Check cannula is undamaged and that the flow path is maintained.- appropriate monitoring must be used at all times.- do not stretch or crush tube.
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