FDA Adverse Event Injury Summary report: N

GREENLINE FIBER OPTIC "D" MACINTOSH #4 BLADE

MDR report key: 1812590 · Received August 16, 2010

Report

Report Number
1036445-2010-00142
Event Type
Injury
Date Received
August 16, 2010
Date of Event
July 7, 2010
Report Date
August 13, 2010
Manufacturer
MEDICAL DEVICES (PVT) LTD
Product Code
CAL
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
TX, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

ONE OF CRNAS INDUCED A PT FOR A GETA, USING A GREENLINE/D MAC #4 BLADE, ATTEMPTED A DIRECT LARYNGOSCOPY. DURING THE LARYNGOSCOPY WITH A SUBSEQUENT GRADE I VIEW OF THE GLOTTIC OPENING AND CORDS. BEFORE INTUBATION COULD BE ACCOMPLISHED, THE GREENLINE BLADE FRACTURED AT THE CONNECTION WITH THE LARYNGOSCOPE HANDLE AND SEPARATED. THE FRACTURED BLADE EDGE LACERATED THE PT'S LIP. IT WAS CONFIRMED THAT THE PIECE WHICH HAD BROKEN OFF WAS RECOVERED AND NOT IN PT'S OROPHARYNX OR OTHERWISE WITHIN THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GREENLINE FIBER OPTIC "D" MACINTOSH #4 BLADE CAL MEDICAL DEVICES (PVT) LTD 5-5332-04 02F

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention