FDA Adverse Event Death Summary report: N

ENDOTRACHEAL TUBE/HI VOLUME/LOW PRESS./CUFFED

MDR report key: 1627578 · Received February 25, 2010

Report

Report Number
9611710-2010-00001
Event Type
Death
Date Received
February 25, 2010
Date of Event
January 26, 2010
Report Date
February 2, 2010
Manufacturer
UNOMEDICAL SDN BHD
Product Code
BTR
PMA / PMN Number
K951696
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B) (4)

Description of Event or Problem · 1

REPORTED BY THE COMPLAINANT AS FOLLOWS... A FEW DAYS AGO A DISTURBING INCIDENT HAPPENED WHEREBY THE ICU TEAM NOTICED A PROBLEM WITH PT WHO WAS ON THE RESPIRATOR DUE TO THE SATURATION ASSESSMENTS WHICH WERE EXTREMELY LOW. THE HEAD NURSE SAID THAT AT A CERTAIN POINT, THE DOCTOR CHECKED THE ETT WITHIN THE THROAT AND REALIZED THAT IT HAD TWISTED ITSELF AND THAT A NEW INTUBATION PROCEDURE HAD TO BE PERFORMED. A FEW DAYS LATER, A SIMILAR EVENT OCCURRED WHEREBY THE ETT TWISTED. RIGHT AFTERWARDS THE PT'S CONDITION BEGAN TO DETERIORATE. THE PT PASSED AWAY A SHORT WHILE AFTER THE OCCURRENCE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOTRACHEAL TUBE/HI VOLUME/LOW PRESS./CUFFED TUBE, TRACHEAL (W/WO CONNECTOR) BTR UNOMEDICAL SDN BHD UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 Death