FDA Adverse Event Malfunction Summary report: N

RUSCH NASOPHARYNGEAL AIRWAY, LATEX FREE

MDR report key: 13026172 · Received December 17, 2021

Report

Report Number
8040412-2021-00328
Event Type
Malfunction
Date Received
December 17, 2021
Date of Event
November 26, 2021
Report Date
November 26, 2021
Manufacturer
TELEFLEX MEDICAL SDN. BHD.
Product Code
BTQ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

QN#(B)(4). THE SAMPLE WAS RETURNED FOR EVALUATION. A VISUAL EXAM WAS PERFORMED AND IT WAS OBSERVED THAT THE SAMPLE CONTAINED VAPORS INSIDE THE PACKAGING. A DEVICE HISTORY RECORD REVIEW WAS PERFORMED AND NO RELEVANT FINDINGS WERE IDENTIFIED. BASED ON THE VISUAL EXAM, THE COMPLAINT HAS BEEN CONFIRMED. A CAPA WAS OPENED TO FURTHER ADDRESS THIS ISSUE.

Additional Manufacturer Narrative · 0

(B)(4).

Description of Event or Problem · 0

IT WAS REPORTED: "WE HAVE 4 UNITS AT THE PHARMACY DEPARTMENT WHICH HAVE NOTICEABLE HUMIDITY IN THEIR PACKAGING". NO PATIENT INVOLVEMENT REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED: "WE HAVE 4 UNITS AT THE PHARMACY DEPARTMENT WHICH HAVE NOTICEABLE HUMIDITY IN THEIR PACKAGING". NO PATIENT INVOLVEMENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1925397 RUSCH NASOPHARYNGEAL AIRWAY, LATEX FREE AIRWAY, NASAL BTQ TELEFLEX MEDICAL SDN. BHD. KMA20K0267

Patients

Seq Age Sex Outcome Treatment
1 Unknown