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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: FISHER & PAYKEL HEALTHCARE LTD FISHER & PAYKEL HEALTHCARE; RESPIRATORY HUMIDIFIER

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FISHER & PAYKEL HEALTHCARE LTD FISHER & PAYKEL HEALTHCARE; RESPIRATORY HUMIDIFIER Back to Search Results
Model Number MR850ALU
Medical Device Problem Code No Audible Alarm (1019)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/10/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Method: the subject mr850 respiratory humidifier was returned to fisher & paykel healthcare in new zealand for investigation, where it was visually inspected and performance tested.Results: visual inspection of the returned device confirmed a piece of lead offcut was found on the speaker cone.Upon removal of the metal piece, the speaker functioned as intended without distortion.Conclusion: the cause of the audible alarm not sounding as intended was due to presence of lead offcuts on the speaker.Our mr850 product technical manual contains a maintenance schedule which instructs the user to conduct annual visual checking and performance testing of the mr850 heater base.In addition, the product technical manual also states that "all servicing procedures should be followed by a humidifier test, and an electrical safety test to ensure proper operation".The mr850 is equipped with visual alarm indicators in addition to the audible alarm.
 
Event or Problem Description
A distributor in chile reported that the audible alarm of an mr850 respiratory humidifier was not functioning properly.There was no reported patient harm.
 
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Brand Name
FISHER & PAYKEL HEALTHCARE
Common Device Name
RESPIRATORY HUMIDIFIER
Manufacturer (Section D)
FISHER & PAYKEL HEALTHCARE LTD
15 maurice paykel place
east tamaki
auckland, 2013
NZ  2013
Manufacturer (Section G)
FISHER & PAYKEL HEALTHCARE LTD
15 maurice paykel place
east tamaki
auckland, 2013
NZ   2013
Manufacturer Contact
diego banuelos
17400 laguna canyon road
suite 300
irvine, CA 92618
9494341005
MDR Report Key20564166
Report Number9611451-2024-00734
Device Sequence Number18034726
Product Code BTT
UDI-Device Identifier09420012407245
UDI-Public(01)09420012407245(10)2103011159(11)240227
Combination Product (Y/N)N
Initial Reporter CountryCI
PMA/510(K) Number
K110019
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Company Representative,Distributor
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 07/19/2024
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 NumberMR850ALU
Device Catalogue NumberMR850ALU
Device Lot Number2103011159
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/01/2024
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/03/2024
Initial Report FDA Received Date10/30/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/27/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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