FDA Adverse Event Malfunction Summary report: N

TRACHEAL TUBE, CUFFED, NASAL PREFORMED

MDR report key: 18629540 · Received February 2, 2024

Report

Report Number
8040412-2024-00036
Event Type
Malfunction
Date Received
February 2, 2024
Date of Event
January 5, 2024
Report Date
January 5, 2024
Manufacturer
TELEFLEX MEDICAL SDN. BHD.
Product Code
BTR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(B)(4).

Additional Manufacturer Narrative · 0

QN#(B)(4). THERE WAS NO ACTUAL SAMPLE OR REPRESENTATIVE SAMPLE RETURNED FOR THIS INVESTIGATION AND NO PHOTO RECEIVED FOR REFERENCE. REVIEW FROM LRR DATA THERE IS ZERO LRR FAILURE REPORTED FOR THIS LOT KME23B3286. WITH LIMITED INFORMATION PROVIDED, NO FURTHER INVESTIGATION COULD BE CONDUCTED. THEREFORE, THIS COMPLAINT IS NOT CONFIRMED.

Description of Event or Problem · 0

THE PHYSICIAN NOTED THAT THE INCORRECT DEVICES WERE RECEIVED. HE ALWAYS AND ONLY ORDERED AND RECEIVED PN 111782 (SEVERAL SIZES) SAFETY SILK NASAL TUBES - CONFIRMED BY SAP - BUT HE RECEIVED PN 111781 (SIZE 4 / 4,5 / 5). THESE 111781 NASAL TUBES ARE MUCH STIFFER THAN THE ORDERED 111782. THE INCORRECT DELIVERY WASN'T NOTED BY THE TRAINEE WHO DID THE INCOMING BOOKING OF THE DEVICES. ASSOCIATED COMPLAINTS 8040412-2024-00030, 8040412-2024-00031, 8040412-2024-00032, 8040412-2024-00033, 8040412-2024-00034, AND 8040412- 2024-00035.

Description of Event or Problem · 0

THE PHYSICIAN NOTED THAT THE INCORRECT DEVICES WERE RECEIVED. HE ALWAYS AND ONLY ORDERED AND RECEIVED PN 111782 (SEVERAL SIZES) SAFETY SILK NASAL TUBES - CONFIRMED BY SAP - BUT HE RECEIVED PN 111781 (SIZE 4 / 4,5 / 5). THESE 111781 NASAL TUBES ARE MUCH STIFFER THAN THE ORDERED 111782. THE INCORRECT DELIVERY WASN'T NOTED BY THE TRAINEE WHO DID THE INCOMING BOOKING OF THE DEVICES. ASSOCIATED COMPLAINTS 8040412-2024-00030, 8040412-2024-00031, 8040412-2024-00032, 8040412-2024-00033, 8040412-2024-00034, 8040412- 2024-00035 AND 8040412-2024-00036.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1572392 TRACHEAL TUBE, CUFFED, NASAL PREFORMED BE, TRACHEAL (W/WO CONNECTOR BTR TELEFLEX MEDICAL SDN. BHD. KME23B3286

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown