BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 133545 · Received November 20, 1997

    Report

    Report Number
    MW1012490
    Event Type
    Malfunction
    Date Received
    November 20, 1997
    Date of Event
    November 6, 1997
    Report Date
    November 14, 1997
    Manufacturer
    OLYMPUS AMERICA, INC.
    Product Code
    EOQ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    O RING ON THE END OF INTUBATION BRONCHOSCOPY LFI BROKE OFF IN THE PT'S BRONCHI WHILE CHECKING PLACEMENT OF DOUBLE LUMEN ET TUBE. AN ADULT BRONCHOSCOPE AND BRONCHOSCOPY FORCEPS WERE USED TO RETRIEVE THE FOREIGN BODY. NO HARM TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * * EOQ OLYMPUS AMERICA, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR