BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KING LT AIRWAY

    MDR report key: 1563140 · Received December 16, 2009

    Report

    Report Number
    MW5014034
    Event Type
    Injury
    Date Received
    December 16, 2009
    Date of Event
    September 17, 2009
    Report Date
    December 4, 2009
    Manufacturer
    KING SYSTEMS CORP.
    Product Code
    CAE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    TUBE FOUND BENT AT AUTOPSY IN GLOTTIS. DATES OF USE: 2009.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KING LT AIRWAY CAE KING SYSTEMS CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Life Threatening