FDA Adverse Event Injury Summary report: N

REDITUBE¿ TRACHEAL TUBE ORAL/NASAL WITH PRELOADED STYLET

MDR report key: 15978308 · Received December 14, 2022

Report

Report Number
8030673-2022-00285
Event Type
Injury
Date Received
December 14, 2022
Date of Event
November 14, 2022
Report Date
December 14, 2022
Manufacturer
WELL LEAD MEDICAL CO. LTD
Product Code
BTR
UDI-DI
10190752148758
PMA / PMN Number
K042683
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

AT THIS TIME, THE SUSPECT DEVICE HAS NOT BEEN RETURNED FOR EVALUATION. NO ROOT CAUSE HAS BEEN DETERMINED YET. VYAIRE MEDICAL WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 0

IT WAS REPORTED TO VYAIRE MEDICAL THAT THE 8070RTC - ET TUBE W/ STYLET, CUFFED SIZE 7 WOULD NOT HOLD AIR IN BALLOON FOR A SPINE PROCEDURE.A DECISION WAS MADE TO FLIP THE PATIENT SUPINE AND REINTUBATE WITH A NEW ETT (ENDOTRACHEAL TUBE). THE CUFF WAS CHECKED PRIOR TO INTUBATION FOR LOSS OF AIR, AND NONE WAS PRESENT BUT A SMALL HOLE IN THE BALLOON CUFF WAS FOUND.AT THIS TIME, THE CUSTOMER HAS NOT PROVIDED ANY INFORMATION REGARDING PATIENT HARM OR INJURY ASSOCIATED WITH THE REPORTED EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2864669 REDITUBE¿ TRACHEAL TUBE ORAL/NASAL WITH PRELOADED STYLET BASIC ENDOTRACHEAL TUBE, SINGLE-USE BTR WELL LEAD MEDICAL CO. LTD ET TUBE W/ STYLET, CUFFED SIZE 7 22A016703K 10190752148758

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention