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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AIRGAS THERAPEUTICS LLC ISPAN GAS TANK REGULATOR (125GM); INTRAOCULAR GAS

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AIRGAS THERAPEUTICS LLC ISPAN GAS TANK REGULATOR (125GM); INTRAOCULAR GAS Back to Search Results
Catalog Number 8065797302
Device Problem Failure to Deliver (2338)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/21/2022
Event Type  malfunction  
Manufacturer Narrative
This report was originally filed under mfg report num 1610287-2022-00021.All future reports will be submitted under mfg report num reflected in this report.No sample was returned for evaluation.A review of the batch production record for the given lot showed no unusual manufacturing issues.A review of the complaint records showed one other complaint against the given lot.That complaint was for issues with the control valve.A review of confirmed complaints for regulators with low or no flow showed 27 complaints since the beginning of 2015 with no additional, related information provided, the customer reported event was not confirmed.The root cause cannot be determined conclusively.Manufacturer will continue to monitor data for evidence of adverse trending and take further action, as appropriate.The manufacturer internal reference number is: (b)(4).
 
Event Description
A nurse reported that during a vitrectomy surgery an ophthalmic regulator failed to dispense gas.Surgery was completed and there was no harm to the patient.
 
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Brand Name
ISPAN GAS TANK REGULATOR (125GM)
Type of Device
INTRAOCULAR GAS
Manufacturer (Section D)
AIRGAS THERAPEUTICS LLC
6141 easton road
p.o. box 310
plumsteadville PA 18949
Manufacturer (Section G)
AIRGAS THERAPEUTICS LLC
6141 easton road
p.o. box 310
plumsteadville PA 18949
Manufacturer Contact
jonathan schlech
6201 south freeway
mail stop ab2-6
fort worth, TX 76134
8007579780
MDR Report Key15813586
MDR Text Key307155315
Report Number1610287-2022-00075
Device Sequence Number1
Product Code LPO
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
P900066
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Nurse
Type of Report Initial
Report Date 11/17/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/17/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number8065797302
Device Lot Number104323
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received10/24/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/12/2021
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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