PERFUSION REPORTS

REPORT
014
DATE
TITLE
Gas Blender Flow Control Immobilised
DETAILS OF INCIDENT

Gas blender flow control knob jammed no flow of gas possible. Perfusionist dis-assembled the knob and could manipulate the flow with a tubing clamp. Having been serviced this subsequently occurred a second time on the device which was only 6 months old. Device returned to manufacturer for a full overhaul and is back in service.

DETAILS OF INJURY TO PATIENT

None

TYPE OF DEVICE/MANUFACTURER

N/A

ACTION TAKEN

Device returned to manufacturer for overhaul. All perfusionists alerted how to avoid and dis-assemble this device if event re-occurs. Other methods of gas supply are currently available in operating room.

RESPONSE FROM MANUFACTURER

N/A

ADDTIONAL INFORMATION

N/A

SUPPORTING VISUALS/VIDEO

N/A

SUPPORTING DOCUMENT

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REPORT NO
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103
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REPORT NO
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REPORT NO
095
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REPORT NO
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REPORT NO
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REPORT NO
092
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REPORT NO
091
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REPORT NO
090
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Breach of chemical cleaner
REPORT NO
089
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Sechrist Gas Blender Sweep on ECMO
REPORT NO
088
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REPORT NO
087
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REPORT NO
086
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REPORT NO
085
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REPORT NO
084
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Damaged roller pump lid
Perfusion Report cards are shown in batches of 30 at any one time where available.
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