BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NIM EMG ENDOTRACHEAL TUBE

    MDR report key: 1812201 · Received August 18, 2010

    Report

    Report Number
    MW5017151
    Event Type
    Injury
    Date Received
    August 18, 2010
    Date of Event
    August 9, 2010
    Report Date
    August 11, 2010
    Manufacturer
    MEDTRONIC XOMED INC.
    Product Code
    BTR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    HI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT WAS INTUBATED BY ANESTHESIA MD. AN AIR LEAK WAS HEARD AND THE DOCTOR REMOVED THE TUBE. HE NOTICED THE ET TUBE HAD A WIRE STICKING THROUGH THE CUFF APPROX 1/4 INCH. A NEW ET TUBE WAS OPENED, BALLOON CHECKED AND PT WAS REINTUBATED. THERE WAS NO HARM TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NIM EMG ENDOTRACHEAL TUBE ET TUBE BTR MEDTRONIC XOMED INC. REF. 8229307 65667300

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Hospitalization