FDA Adverse Event Injury Summary report: N

SHILEY DISPOSABLE CANNULA LPC

MDR report key: 1101807 · Received August 6, 2008

Report

Report Number
2936999-2008-00353
Event Type
Injury
Date Received
August 6, 2008
Date of Event
July 9, 2008
Report Date
July 9, 2008
Manufacturer
COVIDIEN/FORMERLY TYCO HEALTHCARE
Product Code
BTO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

RETURN OF THE DISPOSABLE CANNULA TRACHEOSTOMY TUBE FOR FAILURE INVESTIGATION HAS BEEN REQUESTED. THE LOT NUMBER IS UNK. NO ANALYSIS OR CONCLUSIONS CAN BE DRAWN WITHOUT THE DEVICE OR THE LOT NUMBER. IF THE TUBE IS RETURNED AND FAILURE INVESTIGATION RESULTS PROVIDE SIGNIFICANT INFO, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE TRACHEOSTOMY TUBE WAS IN THE PT FOR 4 DAYS AND THE CUFF DEFLATED DUE TO A LEAK. THE TUBE WAS REMOVED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SHILEY DISPOSABLE CANNULA LPC TRACHEOSTOMY TUBE BTO COVIDIEN/FORMERLY TYCO HEALTHCARE

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention