FDA Adverse Event Malfunction Summary report: N

SAFETY CLR MURPHY CUF ET

MDR report key: 17586326 · Received August 21, 2023

Report

Report Number
8040412-2023-00321
Event Type
Malfunction
Date Received
August 21, 2023
Date of Event
August 1, 2023
Report Date
August 4, 2023
Manufacturer
TELEFLEX MEDICAL SDN. BHD.
Product Code
BTR
UDI-DI
14026704341433
PMA / PMN Number
K961837
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4), COMPLAINT VERIFICATION TESTING COULD NOT BE PERFORMED AS NO SAMPLE WAS RETURNED FOR ANALYSIS. A DEVICE HISTORY RECORD REVIEW WAS PERFORMED, AND NO RELEVANT FINDINGS WERE IDENTIFIED. WITHOUT THE DEVICE TO EVALUATE, THE PROBABLE ROOT CAUSE COULD NOT BE DETERMINED FROM THE AVAILABLE INFORMATION. TELEFLEX WILL CONTINUE TO MONITOR AND TREND FOR REPORTS OF THIS NATURE.

Additional Manufacturer Narrative · 0

QN#(B)(4) .

Description of Event or Problem · 0

IT WAS REPORTED THAT "THE PATIENT WAS INTUBATED, THE DOCTOR INFLATED THE BALLOON AND REALIZED THAT THE BALLOON WAS DEFLATING AND DECIDED TO REMOVE THE TUBE AND PLACE ANOTHER ONE." PER THE CUSTOMER, IT IS UNKNOWN IF THERE WAS ANY PATIENT HARM, DESATURATION OR INJURY OR THE PATIENT'S CURRENT STATUS. IF ADDITIONAL INFORMATION IS RECEIVED, THE COMPLAINT FILE WILL BE UPDATED.

Description of Event or Problem · 0

IT WAS REPORTED THAT "THE PATIENT WAS INTUBATED, THE DOCTOR INFLATED THE BALLOON AND REALIZED THAT THE BALLOON WAS DEFLATING AND DECIDED TO REMOVE THE TUBE AND PLACE ANOTHER ONE." PER THE CUSTOMER, IT IS UNKNOWN IF THERE WAS ANY PATIENT HARM, DESATURATION OR INJURY OR THE PATIENT'S CURRENT STATUS. IF ADDITIONAL INFORMATION IS RECEIVED, THE COMPLAINT FILE WILL BE UPDATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1906418 SAFETY CLR MURPHY CUF ET TUBE, TRACHEAL (W/WO CONNECTOR BTR TELEFLEX MEDICAL SDN. BHD. KME22C2437 14026704341433

Patients

Seq Age Sex Outcome Treatment
1 Unknown