| Brand Name | F&P OPTIFLOW JUNIOR 2 |
| Common Device Name | NASAL CANNULA |
| 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
vargas banuelos
|
| 17400 laguna canyon road |
| suite 300 |
| irvine, CA 92618
|
|
9494341005
|
|
| MDR Report Key | 24951777 |
| Report Number | 9611451-2026-01431 |
| Device Sequence Number | 12078527 |
| Product Code |
BTT
|
| UDI-Device Identifier | 09420012435743 |
| UDI-Public | (01)09420012435743(10)2102968658(11)240202(17)270202 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | JA |
| PMA/510(K) Number | K222197 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility,Company Representative,Distributor |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/24/2026 |
| 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 | OJR410 |
| Device Catalogue Number | OJR410 |
| Device Lot Number | 2102968658 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/24/2026 |
| Supplement Date Received by Manufacturer | 06/11/2026
|
| Initial Report FDA Received Date | 04/22/2026 |
| Supplement Report FDA Received Date | 06/24/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 02/02/2024 |
| 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 |
Concomitant Medical Products and Therapy/Usage Dates | MR850GJU - F&P RESPIRATORY HUMIDIFIER.; RT330 - F&P BREATHING CIRCUIT. |
| Patient Sex | Unknown |