BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PROPPER

    MDR report key: 105739 · Received July 11, 1997

    Report

    Report Number
    2410251-1997-00002
    Event Type
    Malfunction
    Date Received
    July 11, 1997
    Date of Event
    March 5, 1997
    Report Date
    March 6, 1997
    Manufacturer
    PROPPER MFG. CO., INC.
    Product Code
    EQN
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    LARYNGOSCOPY BLADE FAILED DURING INTUBATION IN ER. PT VOMITED AND ASPIRATED WHILE NEW BLADE WAS BEING ATTACHED TO HANDLE. BLADE LOCK SEPARATED FROM HANDLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PROPPER MAC 4 LARYNGOSCOPE BLADE EQN PROPPER MFG. CO., INC. MAC 4.0 F0 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 31 YR Hospitalization