BEUDAMED
    FDA Adverse Event Death Summary report: N

    TRACH TUBE

    MDR report key: 1678017 · Received May 7, 2010

    Report

    Report Number
    MW5015823
    Event Type
    Death
    Date Received
    May 7, 2010
    Date of Event
    December 6, 2009
    Report Date
    May 7, 2010
    Product Code
    JOH
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    PT WAS ADMITTED FOR BRONCHITIS AND ENDED UP WITH A TRACHEOSTOMY. TRACH WAS LOOSE FITTING. LOOSE SKIN COULD BE SEEN AROUND THE TRACH AS WELL AS THE THROAT. PT HAD 6 BRONCHOSCOPIES. TOO MANY PROCEDURES WERE DONE AND LUNGS WERE DAMAGED. HOSPITAL HAD BLOODY RAG WRAPPED AROUND TRACH TO SECURE. TRACH WAS REPLACED LAST DAY OF HIS LIFE. PT DIED ON (B) (6) 2010. PT ALSO ACQUIRED (B) (6) WHILE HOSPITALIZED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRACH TUBE JOH

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Death| O