FDA Adverse Event Injury Summary report: N

SAFETY FLEX CUFFED

MDR report key: 1222520 · Received November 6, 2008

Report

Report Number
2936999-2008-00556
Event Type
Injury
Date Received
November 6, 2008
Date of Event
October 6, 2008
Report Date
October 9, 2008
Manufacturer
COVIDIEN, FORMERLY TYCO HEATLHCARE
Product Code
BTR
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO ANALYSIS OR CONCLUSIONS CAN BE DRAWN WITHOUT THE DEVICE. RETURN OF THE ENDOTRACHEAL TUBE FOR FAILURE INVESTIGATION HAS BEEN REQUESTED. THE LOT NUMBER WAS PROVIDED AND THE MANUFACTURER WILL REVIEW THE LOT HISTORY RECORDS. IF THE TUBE IS RETURNED AND FAILURE INVESTIGATION RESULTS PROVIDE NEW OR SIGNIFICANT INFORMATION, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED "IN USE, AIR LEAKAGE OCCURRED, SO CHANGED TO OTHER TUBE." "WHEN A NURSE CHECKED THE USED TUBE, AIR LEAKAGE DID NOT OCCUR; NO PATIENT INJURED."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SAFETY FLEX CUFFED ENDOTRACHEAL TUBE BTR COVIDIEN, FORMERLY TYCO HEATLHCARE 2007113520

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention