Cases Of Malfunction Research Articles

TECHNOLOGICAL ASPECTS OF THE DEVELOPMENT OF A MIXED FUEL FILTER FOR DIESEL AND BIOFUELS

This article discusses the technological aspects of the development and efficient operation of a fuel filter designed to purify a mixture of diesel and biofuels. The authors analyze the engineering implementation challenges associated with the production and use of this type of filter. The article discusses in detail the technical solutions that determine the efficiency and duration of operation of such a fuel filter in conditions of use of mixed fuel. A separate section is devoted to the study of the impact of mixed fuels on engine operation, with a focus on combustion efficiency and possible cases of malfunction. The article also examines the environmental benefits of using blended fuels, focusing on reduced emissions and positive environmental impacts compared to traditional diesels. Particular attention is paid to innovative materials and technologies used to create fuel filters adapted to mixed fuels. The authors consider the advantages and disadvantages of different materials and their impact on the functionality of the filter. The article concludes with an overview of the standards and regulations that govern the use of blended fuels, with a focus on fuel filter requirements to ensure safety, efficiency, and environmental compliance. Taking into account current trends in the development of fuel systems, the article is aimed at supporting engineers, scientists and specialists from the automotive and energy industries in improving the technologies of blended fuels and their elements.

The Management of Inflatable Penile Prosthesis Erosion and Infection following Iatrogenic Aspiration

The Management of Inflatable Penile Prosthesis Erosion and Infection following Iatrogenic Aspiration

Da Vinci Robotic Surgical System: Early Experience from Pakistan.

To determine the outcomes of robotic surgeries using the Da Vinci robotic surgical system (DVSS) at Pakistan's largest urological tertiary healthcare system. Descriptive study. Place and Duration of the Study: Department of Minimally Invasive and Robotic Surgery, Division of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from March 2017 to December 2021. Hospital records of patients who underwent robotic urological surgeries were assessed for their outcomes in terms of blood loss, mortality, system malfunction, and conversion to open surgery. Descriptive statistics were determined. A total of 550 procedures were performed. The mean age recorded was 39.58±16.83 years. The mean blood loss recorded was 255.611±353.57 ml; there were 3 cases of malfunction. Forty cases were converted to open surgery, and the mortality rate was 1.1%. Minimally invasive surgical techniques have high precision, fewer complications, and lower morbidity rates. Using DVSS for surgical interventions is both effective and safe. Minimally invasive surgery, Da Vinci robotic surgical system, Robotic surgery.

Use of a lockable pigtail catheter (Cook Dawson‐Mueller Multipurpose Drainage Catheter) for nephrostomy reduces the risk of slippage of the catheter

AbstractObjectiveThis study compared the outcomes of using Mac‐Loc catheters and non–Mac‐Loc catheters for percutaneous nephrostomy (PCN). Mac‐Loc catheters have a locking mechanism that forms a curl at the tip by pulling a suture and securing it in place.MethodologyThis retrospective study compared the outcomes of consecutive patients who received PCN with catheters equipped with Mac‐Loc versus those with catheters without Mac‐Loc. Catheter failure was the primary endpoint of the study and was defined as all cases of catheter malfunction after PCN. A propensity score was calculated from covariates based on clinical variables, and patients in each group were matched 1:1 based on the propensity score.ResultsDuring the follow‐up period, a total of 289 cases underwent PCN, 72 with catheters equipped with Mac‐Loc and 217 without Mac‐Loc. Failure of the catheter occurred in 63 cases (22%). There were 44 cases (70%) of slippage, 18 cases (29%) of obstruction, and 1 case (2%) of catheter rupture. After propensity score matching, catheter failure–free survival was significantly higher in the group with catheters equipped with Mac‐Loc than in the group without Mac‐Loc (P = .003).ConclusionsThe use of catheters equipped with Mac‐Loc for PCN reduces the risk of unintentional catheter slippage.

Analysis of Non-fire Alarm Causes using Malfunction Cases by Automatic Fire Detection Equipment Type in Large Shipyards

Non-fire alarms can increase the distrust of employees toward fire signals. In particular, occurrences of non-fire alarms in large shipyards reduce employees’ work efficiency. Therefore, this study entailed an analysis of the causes of non-fire alarms through field investigations to derive a method to reduce non-fire alarms. Of the collected 985 fire signal occurrences, 569 (58%) were abnormal operations for which the causes could not be traced. Excluding these cases, 194 cases of hot work (20%) and 92 cases of water inflow (9%) accounted for the leading causes of non-fire alarms.

변압기 비율차동계전기의 보호협조 운용방안에 대한 알고리즘 개발

Recently, most electrical system failures are difficult to identify with the naked eye due to the trend of cutting-edge and mass capacity of electrical facilities, and the failure section is determined through the operation of the protective relay. In addition, the protection range of the protective relay is wide, and many hours, manpower and costs are involved in the identification of the correct fault site, and electrical safety is a problem. Therefore, in this paper, as a digital ratio differential relay of a power transformer, malfunction cases and occurrence mechanisms of RDR(Ratio Differential Relay), an electrical protection device installed as an automatic shut off device in the event of a transformer internal failure, are analyzed, and the ratio We propose an algorithm for preventing malfunction of differential relay. As a result of analyzing the malfunction characteristics of the ratio differential relay based on the implementation of the proposed algorithm and test device, when the ratio differential relay is operated according to the proposed algorithm, it is possible to prevent malfunction without separate wiring and changing the CT(Current Transformer) installation location. Therefore, it was possible to confirm that the algorithm presented in this paper is useful.

Epidural Analgesia Versus Lumbar Plexus Blockade After Hip Reconstruction Surgery in Children With Cerebral Palsy and Intrathecal Baclofen Pumps: A Comparison of Safety and Efficacy.

Epidural analgesia is commonly used for pain control after reconstructive hip surgery, but its use is controversial in the presence of an intrathecal baclofen pump (ITB). The purpose of this retrospective study was to investigate the rate of serious anesthetic and postoperative complications as well as the efficacy of epidural analgesia compared with lumbar plexus blocks (LPBs) for pain management after neuromuscular hip reconstruction in children with cerebral palsy (CP) and ITB. Pediatric patients with CP and ITB undergoing hip reconstructive surgery from 2010 to 2019 were retrospectively identified. Patients receiving epidural analgesia were compared with those receiving LPB. Morphine milligram equivalents per kilogram were used as a surrogate measure for pain-related outcomes, as pain scores were reported with wide ranges (eg, 0 to 5/10), making it unfeasible to compare them across the cohort. Postoperative complications were graded using the modified Clavien-Dindo classification. Forty-four patients (26/44, 59% male) underwent surgery at an average age of 10.3 years (SD=3.4 y, range: 4 to 17 y). The majority utilized LPB (28/44, 64%) while the remaining utilized epidural (16/44, 36%). There were no differences in rates of serious complications, including no cases of ITB malfunction, damage, or infection. During the immediate postoperative course, patients who received LPB had higher morphine milligram equivalents per kilogram requirements than patients who received epidural analgesia. In patients with CP undergoing hip reconstruction surgery with an ITB in situ, epidural anesthesia was associated with improved analgesia compared with LPB analgesia, with a similar risk for adverse outcomes. Epidural catheters placed using image-guided insertion techniques can avoid damage to the ITB catheter while providing effective postoperative pain control without increasing rates of complications in this complex patient population. Level III.

Investigations of the Usefulness of Dilatometric Methods in the Diagnostics of Combustion Engines

Due to rapidly progressing development in the field of materials used in the automotive industry, research methods enabling the validation of the properties of materials used in specific applications, e.g., engines, are gaining importance. One such method is dilatometry, which belongs to a branch of physics dealing with methods of measuring the thermal expansion of bodies. It includes assessment study of the dependence of body measurements on external conditions. The authors propose that dilatometric methods could be used to diagnose damage and the causes of engine damage that has already occurred. This is a novel approach in diagnostic methods. The aim of the paper was to validate the proposed method for diagnosing of combustion engine components. Two cases of malfunction of this type of device are presented. In the first case, the subject of research is needle-nozzle holder precision pairs used in engines with a power of 150 kW. The main achievement of the research is revealing the occurrence of different thermal expansion values of the materials in the individual nozzle holders, with specific needles in particular causing adverse changes in clearances between these elements. The other case involved tests with respect to engine pistons. The proposed test method allows for a very accurate and relatively quick determination of the degree of damage to their surface. The conducted research confirms the usefulness of dilatometric methods in diagnosing combustion engines—their application makes it possible to determine the causes for the formation of the irregularities. The presented results are promising and enable further development of the methods and their implementation not exclusively with regard to internal combustion engines.

Feasibility of non-invasive measurement of central blood pressure and arterial stiffness in shock.

Patients in haemodynamic shock are in need for an intensive care treatment. Invasive haemodynamic monitoring is state of the art for these patients. However, evolved, non-invasive blood pressure monitoring devices offer advanced functions like the assessment of central blood pressure and arterial stiffness. We analysed the feasibility of two oscillometric blood pressure devices in patients with shock. We performed a monocentre prospective study, enrolling 57 patients admitted to the intensive care unit (ICU), due to septic and/or cardiogenic shock. We assessed invasive and non-invasive peripheral and central blood pressure <24hours and 48hours after admission on the ICU. Additional haemodynamic parameters such as pulse wave velocity (PWV), augmentation pressure and augmentation index were obtained through Mobil-o-Graph PWA (IEM) and SphygmoCor XCEL (AtCor Medical). A complete haemodynamic assessment was successful in all patients (48) with the Mobil-o-Graph 24hours PWA and in 29 patients with the SphygmoCor XCEL (P=.001), when cases of death or device malfunction were excluded. Reasons for failure were severe peripheral artery disease, haemodynamic instability, oedema and agitation. Invasive blood pressure showed a sufficient correlation with both devices; however, large differences between invasive and non-invasive techniques were recorded in Bland-Altmann analysis (P<.05 for all parameters). PWV differed between the two devices. Non-invasive peripheral blood pressure measurement remains a rescue technique. However, non-invasive assessment of arterial stiffness and central blood pressure is possible in patients with septic or cardiogenic shock. Further studies are required to assess their clinical significance for patients in shock.

Modern Medical Innovation on the Preferred Information about the Medicine using AI Technique

The number of mobile Medicare applications has grown exponentially over the past few years, and it is expected to continue to grow soon. The use of health apps promises to be a good way to improve patient care and make work easier for professional. However, some cases of malfunction or misdiagnosis and treatment recommendations have been reported. Regulation is essential to protect users and support product development. So, to suppress the malfunctions we present a pharmacopeia Medicare app in which the customer can see the original profile and the specification of any stimulant with its useful information. This inculcates a clean process which procures a less chance of misapplication of the drugs. These mobile medical app companies have improved access to clinical references and point of care tools. However, it is difficult to identify mobile medical apps that are suitable for the practice of pharmacy. This app is entirely based on our experience in accrediting websites with health-related content and journal.

A FROSTY CASE OF FACIAL FROSTBITE IN THE FACE OF LIQUID OXYGEN

SESSION TITLE: Medical Student/Resident Respiratory Care SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Long-term oxygen therapy (LTOT) is used by more than 1.5 million US adults and has been shown to both decrease mortality and increase quality of life in hypoxemic COPD. Many mechanical injuries involving LTOT are user directed and occur when a heat source ignites purified oxygen (O2), such as cigarettes. Here, we report the first English case of frostbite injury to the face due a malfunctioning liquid oxygen (LOx) canister. CASE PRESENTATION: Our patient was an 80-year-old female with a significant past medical history of COPD who presented to the emergency room with epistaxis and mucopurulent rhinorrhea after her nasal cannula (NC) was found frozen to her face. It was reported that LOx traveled up her NC. On physical exam, she had multiple second and third-degree burns on her nose, throat, lips, cheeks, and neck. She was placed on an open non-rebreather mask, and her facial frostbite was empirically treated with vancomycin and ampicillin-sulbactam for fourteen days to prevent cavernous sinus thrombosis. Otolaryngology was consulted to debride her wounds and open her nasal passages. A PEG tube was required to maintain her nutritional status. Towards the end of her fourteen-day hospital stay, her burns had shrunk and become more demarcated. However, the patient became febrile and complained of a painful headache. A CT of her head revealed acute sphenoid sinusitis, for which she was discharged on amoxicillin-clavulanic acid and doxycycline for an additional seven days. DISCUSSION: A cryogenic LOx tank consists of two vessels: an inner chamber where the LOx is kept cool by an insulated area around it from which air is removed, and an outer chamber which consists of a vaporizer that converts LOx into a gaseous state [1]. O2 is cooled to less than -183°C to achieve its liquid form for storage and transportation efficiency [1], as one liter of LOx offers 860 liters of gaseous O2. This large liquid-to-gas expansion ratio can generate an enormous amount of pressure. One case study describing frostbite injury due to a compressed gaseous O2 tank postulated that it was caused by pressure regulation failure, and showed that increasing amounts of pressure led to a significant decrease in temperature of the compressed air [1]. Similarly, we believe that our patient’s LOx pressure release system malfunctioned, driving a large outflow of unconverted LOx to penetrate the vapor chamber, enter her NC, and freeze her face. Unlike typical frostbite, burns involving LOx occur over seconds and are more likely to infiltrate underlying tissue compared to thermal burns. Removal of the LOx and rewarming as soon as possible should be done to prevent further damage [2]. CONCLUSIONS: The broad utilization of LTOT can invite extremely rare cases of hardware malfunction that may cause severe injury. Safety protocols and schedules should be strictly followed for refilling and handling O2 storage equipment. Reference #1: Jabbour, N., Heman-Ackah, S. E., Day, A. T., & Odland, R. (2011). Severe nasal frostbite injury from nasal cannula supplemental oxygen malfunction. American Journal of Otolaryngology, 32(4), 349–352. doi:10.1016/j.amjoto.2010.03.009 Reference #2: Uygur, F., Sever, C., & Noyan, N. (2009). Frostbite Burns Caused by Liquid Oxygen. Journal of Burn Care & Research, 30(2), 358–361. doi:10.1097/bcr.0b013e318198a769 DISCLOSURES: No relevant relationships by Olson Knight, source=Web Response No relevant relationships by munir shah, source=Web Response No relevant relationships by Parth Shah, source=Web Response No relevant relationships by Krupa Solanki, source=Web Response

Study of the characteristics of temperature rise and coolant flow rate control during malfunction of PEM fuel cells

In actual PEM fuel cell systems, the coolant flow rate is generally controlled to maintain a preset temperature at the coolant outlet. This implies that a change in coolant supply flow rate is a good early indicator of a malfunctioning PEM fuel cell stack and system components. In this study, various fuel cell malfunctions are simulated based on the practical coolant flow control strategy by using a three-dimensional, two-phase, multiscale PEM fuel cell model developed in our previous studies. The focus is on analysis of the characteristics of coolant flow rate change along with voltage degradation in various fuel cell malfunction cases. The model predictions show that in general, the coolant flow rate tends to increase proportionally with the degree of voltage degradation, but the increase in temperature inside the membrane electrode assembly (MEA) is not always related to the voltage drop and is influenced more directly by local current density distribution. Although the present numerical comparison between the normal and malfunctioning cases is conducted at the low current density of 0.3 A cm−2, the general cell behavior will not be altered at higher current densities due to inverse relationship between cell performance and waste heat generation. The present work elucidates the complex interplay among increase in coolant flow rate, increase in MEA temperature, voltage drop, and change in local current density distribution when a PEM fuel cell malfunctions.

Malfunction of a ventriculoperitoneal shunt during pregnancy

Bringing a pregnancy to term is possible for a woman carrying a ventriculoperitoneal bypass valve, however, pregnancy can be a source of malfunction of the bypass system. We report two cases of malfunction of a VPS during the pregnancy's 3rd trimester in two patients aged 25 and 30 years respectively. The valve was examined in both cases and the persistence of the neurological signs required a cesarean section. The diagnostic aspects and management strategies were discussed as regards these two cases and throughout the literature review.

Impact of Model Complexity in the Monitoring of Machine Tools Condition Using Volumetric Errors

The scale and master ball artefact (SAMBA) method allows estimating the inter- and intra-axis error parameters as well as volumetric errors (VEs) of a five-axis machine tool by using simple ball artefacts and the machine tool’s own touch-trigger probe. The SAMBA method can use two different machine error models named after the number of model parameters, i.e., the “13” and “84” machine error models, to estimate the VEs. In this study, we compare these two machine error models when using VE vector directions and values for monitoring the machine tool condition for three cases of machine malfunctions: 1) a C-axis encoder fault, 2) an induced X-axis linear positioning error, and 3) an induced straightness error simulated fault. The results show that the “13” machine error model produces more focused concentrated VE directions but smaller VE values when compared with the “84” machine error model; furthermore, although both models can recognize the three faults and are effective in monitoring the machine tool condition, the “13” machine error model achieves a better recognition rate of the machine condition. This paper provides guidelines for selecting machine error models for the SAMBA method when using VEs to monitor the machine tool condition.

PL02: Double Sequential External Defibrillation for Refractory Ventricular Fibrillation: the DOSE VF pilot randomized controlled trial

Introduction: Despite recent advances in resuscitation, some patients remain in ventricular fibrillation (VF) after multiple defibrillation attempts during out-of-hospital cardiac arrest (OHCA). Vector change defibrillation (VC) and double sequential external defibrillation (DSED) have been proposed as alternate therapeutic strategies for OHCA patients with refractory VF. The primary objective was to determine the feasibility, safety and sample size required for a future cluster randomized controlled trial (RCT) with crossover comparing VC or DSED to standard defibrillation for patients experiencing refractory VF. Secondary objectives were to evaluate the intervention effect on VF termination and return of spontaneous circulation (ROSC). Methods: We conducted a pilot cluster RCT with crossover in four Canadian paramedic services and included all treated adult OHCA patients who presented in VF and received a minimum of three defibrillation attempts. In addition to standard cardiac arrest care, each EMS service was randomly assigned to provide continued standard defibrillation (control), VC or DSED. Services crossed over to an alternate defibrillation strategy after six months. Prior to the launch of the trial, 2,500 paramedics received in-person training for VC and DSED defibrillation using a combination of didactic, video and simulated scenarios. Results: Between March 2018 and September 2019, 152 patients were enrolled. Monthly enrollment varied from 1.4 to 6.1 cases per service. With respect to feasibility, 89.5% of cases received the defibrillation strategy they were randomly allocated to, and 93.1% of cases received a VC or DSED shock prior to the sixth defibrillation attempt. There were no reported cases of defibrillator malfunction, skin burns, difficulty with pad placement or concerns expressed by paramedics, patients, families, or ED staff about the trial. In the standard defibrillation group, 66.6% of cases resulted in VF termination, compared to 82.0% in VC and 76.3% of cases in the DSED group. ROSC was achieved in 25.0%, 39.3% and 40.0% of standard, VC and DSED groups, respectively. Conclusion: Findings from our pilot RCT suggest the DOSE VF protocol is feasible and safe. VF termination and ROSC were higher with VC and DSED compared to standard defibrillation. The results of this pilot trial will allow us to inform a multicenter cluster RCT with crossover to determine if alternate defibrillation strategies for refractory VF may impact patient-centered, clinical outcomes

Short-term single-centre experience with the HeartMate 3 left ventricular assist device for advanced heart failure.

The objective of this study was to analyse clinical characteristics, survival and adverse events of patients with advanced heart failure supported using the Abbott HeartMate 3 left ventricular assist device (LVAD). We retrospectively reviewed 42 consecutive HeartMate 3 recipients implanted in our centre between 1 November 2015 and 31 October 2019. Our series comprised 39 males, aged 56.7 ± 11.8 years. Eleven (26%) patients had preimplant INTERMACS clinical profiles of 1 or 2. The mean duration support was 14.0 ± 10.6 months (range 0.69-44 months). During follow-up, 4 (10%) patients died while on support, 13 (35%) patients received a heart transplant and 25 patients are still ongoing. Actuarial survival after LVAD implantation was 88.4 ± 5.5% and 84.4 ± 6.6% at 1 and 2 years, respectively. There were no cases of pump thrombosis or technical malfunction. Seven (17%) patients required post-implant temporary right ventricular support. Adverse events included bleeding requiring surgery in 13 (31%) patients, gastrointestinal bleeding in 6 (14%) patients, LVAD-specific infections in 19 (45%) patients and non-disabling ischaemic stroke in 5 (12%) patients. The incidence of ischaemic stroke was significantly higher in patients where the outflow graft was anastomosed to the descending aorta as compared to those where it was anastomosed to the ascending aorta (P < 0.003). We have observed satisfactory survival rates using the HeartMate 3 LVAD for long-term mechanical circulatory support. The absence of technical failure, pump thrombosis, haemolysis or need for pump exchange during our 4-year experience confirms its technical reliability and improved haemocompatibility, but bleeding complications and infections remain a concern.

An unusual cause of intraoperative high airway pressure and ventilator failure: message to be learned

Failure of ventilation of an anesthetised patient due to problems in mechanical ventilator is not uncommon. The proper functioning of machine should be ensured before anesthetising a patient by the automated checking system or manually by the attending anaesthesiologist. However, sudden malfunction of some system of the machine during operation may cause the ventilator to stop risking the patient’s life. About one third of the equipment problems are due to anesthesia machine and one quarter of the problems are due to human error. We present a case of malfunction of anesthesia ventilator due to an unusual cause of blockage of anesthesia gas scavenging system.

AN UNUSUAL CAUSE OF INTRAOPERATIVE HIGH AIRWAY PRESSURE AND VENTILATOR FAILURE: MESSAGE TO BE LEARNED

Failure of ventilation of an anesthetised patient due to problems in mechanical ventilator isnot uncommon. The proper functioning of machine should be ensured before anesthetisinga patient by the automated checking system or manually by the attending anaesthesiologist.However, sudden malfunction of some system of the machine during operation may causethe ventilator to stop risking the patient’s life. About one third of the equipment problemsare due to anesthesia machine and one quarter of the problems are due to human error. Wepresent a case of malfunction of anesthesia ventilator due to an unusual cause of blockage ofanesthesia gas scavenging system.

Diagnosis of Ventriculoperitoneal Shunt Malfunction: A Practical Algorithm

This study aims to present a practical method to accurately diagnose ventriculoperitoneal shunt (VPS) malfunction and to detect the exact level at which the system has failed to tailor VPS revision at that level only. A tertiary referral single-center algorithm for diagnosis of VPS malfunction is proposed. Based on clinical symptoms and confirmed ventricular dilatation on computed tomography, the VPS reservoir is punctured; if no cerebrospinal fluid is obtained, ventricular catheter replacement is recommended. Conversely, if cerebrospinal fluid is obtained, a sample is sent for cultural examination and the macroscopic integrity of the whole system is checked via plain radiography in the angiographic suite. Then, through the injection of iodate contrast medium into the reservoir and selective exclusion of the proximal and distal catheters, the patency and correct VPS functioning are investigated. A total of 102 (56 males) patients (mean age, 41.5 years; range, 1-86 years) underwent a VPS function test from 2012 to 2018: 59 cases of VPS malfunction (57.8%) were diagnosed. Ventricular catheter obstruction/damage/displacement occurred in 12/59 patients (20.3%), valve damage in 11/59 patients (18.6%), distal catheter obstruction/damage/displacement in 17/59 patients (28.8%) and 2-level (valve/proximal catheter or valve/distal catheter) obstruction/damage/displacement in 16/59 patients (27.1%). Subclinical infection was diagnosed in 3 patients (5.1%). VPS revision was performed selectively at the level of failure. The proposed algorithm is a practical, simple and minimally invasive technique to accurately diagnose VPS malfunction, identifying the exact level of system failure and allowing surgical VPS revision to be tailored, avoiding unnecessary complete system replacement.

Literature Review on the Incidence of Primary Stapler Malfunction

Background. Surgical stapling devices are known for their reliability and convenience. A letter to health care professionals published by the US Food and Drug Administration in March 2019 highlighted the increasing number of adverse events associated with surgical staplers. Driven by a case of stapler malfunction during an elective laparoscopic sleeve gastrectomy, we performed a literature review to investigate the incidence of primary stapler malfunction. We also discuss the common types and an approach to its management. Methods. PubMed, MEDLINE, and EMBASE databases were searched for articles discussing surgical stapler malfunction. Twelve studies were selected that described the incidence and/or consequences of primary stapler malfunction. A narrative synthesis was performed. Results. From observational studies, the incidence ranged from 0.022% to 2.3%. A prospective survey reported that 86% of laparoscopic surgeons either had personal experience with or knew of surgeons who experienced stapler malfunction, implying a higher incidence. Underreporting has been an issue as manufacturers can get exemptions from public reporting. Significantly, higher malfunctions have been reported after exemptions were lifted. The most common types of stapler malfunction are stapler misfire and stapler locking. Major morbidity and mortality have been reported. Conclusion. Surgeons are increasingly reliant on technological innovations. Stapling failure occurs and it is imperative to be aware of this. Given the high volume of stapler use, a high percentage of surgeons are likely to encounter this problem in their career. It is important to have an approach to the prevention and management of this potentially catastrophic complication.