BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SAGE TOOTHETTE SUCTION SWAB

    MDR report key: 1201963 · Received October 15, 2008

    Report

    Report Number
    MW5008605
    Event Type
    Injury
    Date Received
    October 15, 2008
    Date of Event
    September 11, 2008
    Report Date
    October 15, 2008
    Manufacturer
    SAGE PRODUCTS INC.
    Product Code
    KXF
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    REPORTER STATES THAT IN 2008, HER BROTHER'S VITAL SIGNS DIMINISHED WHILE IN THE HOSPITAL, AND A "CODE BLUE" HAD TO BE CALLED. WHEN THE DOCTOR TRIED TO VENTILATE THE PT, AN OBSTRUCTION WAS FELT AND A BRONCHOSCOPE WAS DONE. A PIECE OF GREEN SPONGE WAS FOUND IN THE PATIENT'S LUNG, REPORTER WAS TOLD THAT THIS WAS THE CAUSE OF HER BROTHER'S LUNGS TO COLLAPSE. REPORTER STATES THAT SHE HAS RESEARCHED AND FOUND SIMILAR REPORTS ON WEB.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAGE TOOTHETTE SUCTION SWAB NONE KXF SAGE PRODUCTS INC. 6550 *

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR