BEUDAMED
    FDA Adverse Event Death Summary report: N

    E-TAD

    MDR report key: 169013 · Received May 20, 1998

    Report

    Report Number
    169013
    Event Type
    Death
    Date Received
    May 20, 1998
    Date of Event
    May 2, 1998
    Report Date
    May 19, 1998
    Manufacturer
    HOLLISTER, INC.
    Product Code
    CBH
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    INADVERTANT EXTUBATION OF PARALYZED/SEDATED PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 E-TAD ORAL ENDOTRACHEAL TUBE ATTACHMENT DEVICE CBH HOLLISTER, INC. 9789 *

    Patients

    Seq Age Sex Outcome Treatment
    1 30 YR Death