FDA Adverse Event Injury Summary report: N

SUNMED LLC

MDR report key: 16258591 · Received January 27, 2023

Report

Report Number
1314417-2023-00003
Event Type
Injury
Date Received
January 27, 2023
Date of Event
December 30, 2022
Report Date
January 27, 2023
Manufacturer
SUNMED HOLDINGS LLC
Product Code
CAE
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

MCKESSON LARYNGEAL MASK IS USED IN ACHIEVING AND MAINTAINING CONTROL OF THE AIRWAY DURING ROUTINE AND EMERGENCY ANESTHETIC PROCEDURES IN FASTED PATIENTS. DURING THE PROCEDURE, THE AIRWAY TUBE IS CAUSING SOFT TISSUE INJURY TO PATIENTS. COMPLAINT CONFIRMED WITH PHOTO. REVIEWED THE COMPLAINT HISTORY FOR THE 24 MONTHS PRECEDING THE COMPLAINT REPORTING DATE. THERE WERE ONLY 2 COMPLAINTS FOR THE PARTS LISTED IN THE COMPLAINT IN THAT TIMEFRAME. DISCUSSED WITH CLINICAL SUBJECT MATTER EXPERT AND DETERMINED THE MOST LIKELY ROOT CAUSE OF CLINICIAN USER ERROR. VISUALLY INSPECTED SIMILAR PART 159-001 INVENTORY AND NO NON-CONFORMANCES WERE FOUND. PERFORMED RISK ANALYSIS WITH (B)(6) AND DETERMINED A SEVERITY RATING OF 7/10. SENT RESOLUTION TO THE CUSTOMER.

Additional Manufacturer Narrative · 0

MCKESSON LARYNGEAL MASK IS USED IN ACHIEVING AND MAINTAINING CONTROL OF THE AIRWAY DURING ROUTINE AND EMERGENCY ANESTHETIC PROCEDURES IN FASTED PATIENTS. DURING THE PROCEDURE, THE AIRWAY TUBE IS CAUSING SOFT TISSUE INJURY TO PATIENTS.

Description of Event or Problem · 0

CAUSING SOFT TISSUE INJURIES TO PATIENTS.

Description of Event or Problem · 0

CAUSING SOFT TISSUE INJURIES TO PATIENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
401163 SUNMED LLC MCKESSON LARYNGEAL MASK - PVC DISPOSABLE, SIZE 3, 4, 5, CAE SUNMED HOLDINGS LLC 159-003, 004, 005 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other