MAUDE Adverse Event Report: FISHER & PAYKEL HEALTHCARE LIMITED FLEXITRUNK INFANT NASAL TUBING; BZO

Model Number	BC190
Medical Device Problem Code	Material Split, Cut or Torn (4008)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/07/2022
Type of Reportable Event	Malfunction
Event or Problem Description
A healthcare facility in china reported that the bc190 flexitrunk infant nasal tubing was found to be damaged when taken out of its packaging.There was no patient involvement.
Additional Manufacturer Narrative
(b)(4).Fisher and paykel (f&p) are currently in the process of obtaining further information regarding the reported event.We will provide a follow up report upon completion of our investigation.
Additional Manufacturer Narrative
(b)(4).Correction: since our initial report we have identified that this report is a duplicate to (b)(4) (fda report number # (b)(4).Therefore the following sections have been corrected b3, b4, b5, e1.Method: the complaint bc190 flexitrunk infant nasal tubing was returned to fisher & paykel healthcare (f&p) in new zealand for investigation where it was inspected by a trained f&p technician.Results: visual inspection of the returned bc190 flexittrunk infant nasal tubing revealed that the entire tubing was damaged, and a section of the tubing was taped.It was also revealed that the film was wrinkled and torn indicating that a force was applied.It was also noted that both circuit connectors were missing.Conclusion: we are unable to determine the cause of the reported event.All flexitrunk nasal tubings are visually inspected, and pressure tested before leaving the production line and those that fail are rejected.This suggests that the damage on the subject nasal tubing occurred after it was released for distribution.Our user instructions the accompany the flexitrunk infant nasal tubing state: - "use caution when positioning the infant interface.Avoid excessive pull forces, sharp objects and tubing holders.Damage to the tubing may cause loss of pressure and require immediate replacement.".
Event or Problem Description
A distributor in china reported on behalf of a healthcare facility, that the bc190 flexitrunk infant nasal tubing was found to be damaged after patient use.There was no patient involvement as the issue was found whilst the device was not in use on a patient.

• Brand Name: FLEXITRUNK INFANT NASAL TUBING
• Common Device Name: BZO
• Manufacturer (Section D): FISHER & PAYKEL HEALTHCARE LIMITED; 15 maurice paykel place; east tamaki; auckland, 2013 ; NZ 2013
• Manufacturer (Section G): FISHER & PAYKEL HEALTHCARE LIMITED; 15 maurice paykel place; east tamaki; auckland, 2013 ; NZ 2013
• Manufacturer Contact: faranak gomarooni ; 17400 laguna canyon road; suite 300; irvine, CA 92618 ; 9494534000
• MDR Report Key: 15920659
• Report Number: 9611451-2022-01113
• Device Sequence Number: 17782640
• Product Code: BZO
• UDI-Device Identifier: 09420012413390
• UDI-Public: (01)09420012413390(10)2101897316(11)211113
• Combination Product (Y/N): N
• Initial Reporter Country: CH
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Distributor
• Initial Reporter Occupation: Nurse
• Type of Report: Initial,Followup
• Report Date (Section B): 11/07/2022

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
• Operator of Device: Health Professional
• Device Model Number: BC190
• Device Catalogue Number: BC190
• Device Lot Number: 2101897316
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 11/08/2022
• Supplement Date Received by Manufacturer: 12/06/2022
• Initial Report FDA Received Date: 12/05/2022
• Supplement Report FDA Received Date: 12/13/2022
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 11/13/2021
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown