GE Healthcare appreciates the opportunity to respond to the Letter to the Editor from Drs. Seif and Olympio,1pertaining to the Aestiva CO2absorbent cartridge issue. We thank you for your diligence in informing the anesthesiology community regarding this case and were impressed by your quick actions in solving the issue at hand.

GE Healthcare has shipped almost 2 million Medisorb cartridges with this exact design over the last 10 yr. After reviewing our database for similar events, we found no record of such a problem being previously reported. Your experience demonstrates that this unique human-induced failure can occur, and your report will help raise awareness to further reduce the likelihood of occurrence.

Furthermore, we tested absorbent cartridges from a few alternative vendors and found they are also unidirectional. The consistency of this unidirectional design may be due to the fact that a taper is required for normal manufacturing as part of the molding process. The taper also allows for proper positioning (centering) of the cartridge in the canister to adequately maintain a seal.

You effectively addressed the issue by swapping the canister. These canisters (0229-3015-800) are available for order in case you would like to have extra canisters available at your facility.

Thank you once again for bringing this to the attention of the anesthesia community.

, GE Healthcare, Madison, Wisconsin.

Seif DM, Olympio MA. Expiratory limb ventilation during unique failure of the anesthesia machine breathing circuit. ANESTHESIOLOGY. 2013;118:751–3 (Accepted for publication December 11, 2012)