BEUDAMED
    FDA Adverse Event Other Summary report: N

    TYCO HEALTHCARE

    MDR report key: 1621613 · Received February 25, 2010

    Report

    Report Number
    MW5014949
    Event Type
    Other
    Date Received
    February 25, 2010
    Date of Event
    February 19, 2010
    Report Date
    February 25, 2010
    Manufacturer
    TYCO HEALTHCARE GROUP LP NELLCOR PURITAN BENNETT DIV.
    Product Code
    JOH
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    TRACHEOSTOMY TUBE WAS INSERTED IN PT ON (B) (6) 2010 AND HAD TO BE REPLACED ON (B) (6) 2010 BECAUSE, THE CUFF WOULD NOT HOLD AIR. SHILEY # 6 LPC, (B) (4). DATES OF USE: (B) (6) 2010 - (B) (6) 2010. DIAGNOSIS OR REASON FOR USE: VENTILATOR SUPPORT AIRWAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TYCO HEALTHCARE SHILEY #6 LPC JOH TYCO HEALTHCARE GROUP LP NELLCOR PURITAN BENNETT DIV. LPC 0902001779

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Other