FDA Adverse Event Injury Summary report: N

SHILEY DCT

MDR report key: 1024366 · Received April 2, 2008

Report

Report Number
2936999-2008-00148
Event Type
Injury
Date Received
April 2, 2008
Date of Event
March 7, 2008
Report Date
March 7, 2008
Manufacturer
HENEQUEN
Product Code
BTO
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE TUBE WAS DISCARDED AND THEREFORE NOT AVAILABLE FOR FAILURE INVESTIGATION. THE LOT NUMBER IS UNKNOWN. NO ANALYSIS OR CONCLUSIONS CAN BE DRAWN WITHOUT THE DEVICE OR THE LOT NUMBER. A MANUFACTURING CAPA IS ALREADY IN PLACE TO ADDRESS CUFF LEAKS.

Description of Event or Problem · 1

A DOCTOR REPORTED A SHILEY DCT TRACHEOSTOMY TUBE WITH A CUFF LEAK. THE TUBE WAS DISCARDED AND HE DID NOT KNOW THE LOT NUMBER. IT IS NOT KNOWN IF THE CUFF LEAK WAS FOUND DURING PRE-TEST OR AFTER INSERTION ON A PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SHILEY DCT TRACHEOSTOMY TUBE BTO HENEQUEN DCT

Patients

Seq Age Sex Outcome Treatment
1