FDA Adverse Event Malfunction Summary report: N

CURITY

MDR report key: 10313248 · Received July 23, 2020

Report

Report Number
8040459-2020-00043
Event Type
Malfunction
Date Received
July 23, 2020
Date of Event
June 22, 2020
Report Date
July 23, 2020
Manufacturer
KENDALL GAMMATRON, THAILAND
Product Code
BTR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TW
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS PRODUCT IS NOT SOLD IN US AND IS 510(K) EXEMPT. THIS REPORT IS ASSOCIATED TO A SIMILAR PRODUCT SOLD IN THE US WITH 510(K) NUMBER K892432. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

ACCORDING TO THE REPORTER, PREOPERATIVELY, THE DEVICE'S PILOT BALLOON WAS UNABLE TO INFLATE. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
778033 CURITY TUBE, TRACHEAL (W/WO CONNECTOR) BTR KENDALL GAMMATRON, THAILAND 9475E 1609658FED

Patients

Seq Age Sex Outcome Treatment
1