MAUDE Adverse Event Report: AIRGAS THERAPEUTICS LLC ISPAN GAS TANK REGULATOR; INTRAOCULAR GAS

Catalog Number 8065797303

Device Problem Appropriate Term/Code Not Available (3191)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Type  malfunction  

Manufacturer Narrative

Investigation including root cause analysis is in progress.A supplemental mdr will be filed as necessary in accordance with 21 cfr 803.56 when additional reportable information becomes available.The manufacturer internal reference number is: (b)(4).

Event Description

A customer reported that during surgery when opened a new cylinder for sulphur hexafluoride (sf6) did show that the cylinder is full and took only 10 cc from it, then the regulator went to the empty sign right away.The procedure was completed.

Manufacturer Narrative

The manufacturer internal reference number is: (b)(4).

Event Description

Additional information received indicated that regulator was missing an o-ring and that is why the gas had leaked from the sulphur hexafluoride (sf6) cylinder.

Manufacturer Narrative

A check of the batch production record for the sf6 gas showed no unusual manufacturing issues.A check of the batch production record for the regulator could not be performed because a valid lot number was not reported.The manufacture date could not be determined.A check of the complaint records showed no other complaints against lot of sf6 gas.A check of the complaint records for the regulator could not be performed because a valid lot number was not provided.The cylinder was weighed and found to be empty.No regulator was returned for evaluation.The cylinder was filled with 500 psi of nitrogen and checked for leaks, no leaks could be detected.The pressure was rechecked four days later and found to be unchanged.The customer complaint could not be duplicated.With no additional, related information provided, the customer reported event was not confirmed for the regulator.At this time, the root cause of the reported event cannot be determined.No corrective action can be taken.No further information was able to be obtained from this customer.With no additional, related information provided, the reported event was not able to be confirmed.Based upon the information provided, the root cause of the reported event cannot be determined.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).

• Brand Name: ISPAN GAS TANK REGULATOR
• 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 Key: 16085498
• MDR Text Key: 308589825
• Report Number: 2518435-2023-00002
• Device Sequence Number: 1
• Product Code: LPO
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: P900066
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial,Followup,Followup
• Report Date: 05/22/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 01/03/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 8065797303
• Device Lot Number: ASKU
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 04/24/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Treatment: ISPAN SULFUR HEXAFLUORIDE (SF6) GAS.