BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LAYRNG-O-JET KIT

    MDR report key: 12040327 · Received June 21, 2021

    Report

    Report Number
    MW5101996
    Event Type
    Injury
    Date Received
    June 21, 2021
    Date of Event
    June 10, 2021
    Report Date
    June 16, 2021
    Product Code
    OGH
    UDI-DI
    00376329630052
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING INTUBATION THE LTA SYRINGE TIP BROKE APPROXIMATELY 1-2" LONG AND FELL IN PATIENT'S AIRWAY. ANESTHESIA ATTEMPTED TO LOOK FOR THE BROKEN TIP AND WAS ABLE TO LOCATE IT FOR A MOMENT USING THE GLIDESCOPE, BUT THEN IT DISAPPEAR. ADDITIONAL ANESTHESIOLOGIST CALLED AND CAME TO THE ROOM TO HELP TAKE OUT THE BROKEN TIP USING GLIDESCOPE AND BRONCHOSCOPE BUT HE WAS UNSUCCESSFUL. THE SURGERY STARTED WITH THE BROKEN TIP STILL INSIDE PATIENT'S THROAT, AFTER THE SURGERY WAS FINISHED THE RELIEVING ANESTHESIOLOGIST TRIED TO LOOK FOR THE TIP AGAIN WITH GLIDESCOPE AND BRONCHOSCOPE, BUT NOTHING WAS FOUND IN THE TRACHEA OR MAIN BRONCHI - SUSPECTED INTO THE ESOPHAGUS. XRAY AND CT OF CHEST/NECK/ABDOMEN/PELVIS NEGATIVE, GI CONSULTED AND FAVORED ALLOWING THE FOREIGN BODY TO PASS THROUGH THE GI SYSTEM. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    934180 LAYRNG-O-JET KIT LARYNGOSCOPE KIT OGH DJ055J0 00376329630052

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Other