FDA Issues Safety Notice on Nitric Oxide Delivery System

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FDA has issued a correction notice for NOxBOX Ltd.’s NOxBOXi Nitric Oxide Delivery System after reports of dosing fluctuations when the device is used with the Bunnell LifePulse High Frequency Jet Ventilator and possibly other conventional ventilators. The agency warned that the problem can interrupt nitric oxide therapy and lead to serious, potentially life-threatening complications.

NOxBOX Ltd., a subsidiary of Linde Gas & Equipment Inc., says customers had reported swings greater than 20% from the intended nitric oxide dose under specific LifePulse settings. Such fluctuations may reduce oxygen levels in the blood (desaturation) or increase pressure in the pulmonary artery, which carries blood from the heart to the lungs, it says. According to the company, three serious injuries have been reported.  

The company says its NOxBOXi system is used to deliver and monitor inhaled nitric oxide therapy, along with nitrogen dioxide and oxygen levels, in a patient’s ventilator circuit. Nitric oxide is commonly used in critical care settings to support oxygenation in neonates and other vulnerable patients. It says it is developing a new software version that will correct the dosing fluctuation problem.

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