BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KENDALL ARGYLE

    MDR report key: 1211155 · Received October 24, 2008

    Report

    Report Number
    1211155
    Event Type
    Injury
    Date Received
    October 24, 2008
    Date of Event
    September 12, 2008
    Report Date
    October 23, 2008
    Manufacturer
    COVIDIEN
    Product Code
    JOL
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHILE THE NURSE WAS SUCTIONING THE PT, THE PT BROKE OFF THE TIP OF THE YANKAUER SUCTION TUBE. THE GASTROENTEROLOGIST WAS CALLED AND HE RETRIEVED THE PIECE THAT MEASURED 4.5 X 1 X 0.8 CM. THE PT TOLERATED THE PROCEDURE WITH NO FURTHER SEQUELAE. TIP SENT TO PATHOLOGY TO ASSESS WHETHER PROD DEFECT, INDETERMINATE. AFTER REVIEW, IT WAS DECIDED TO REPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KENDALL ARGYLE YANKAUER SUCTION TUBE JOL COVIDIEN 8888505016

    Patients

    Seq Age Sex Outcome Treatment
    1 78 YR Life Threatening