FDA Adverse Event Malfunction Summary report: N

HUDSON HCH AQUA+ FILTER

MDR report key: 1922107 · Received November 18, 2010

Report

Report Number
8040412-2010-00092
Event Type
Malfunction
Date Received
November 18, 2010
Date of Event
July 27, 2010
Report Date
November 3, 2010
Manufacturer
TELEFLEX MEDICAL
Product Code
CAH
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE RESULTS OF THE INVESTIGATION ARE NOT AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CONNECTING PART OF THE FILTER CRACKED AFTER IT WAS CONNECTED TO THE ENDOTRACHEAL TUBE. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON HCH AQUA+ FILTER HCH FILTER CAH TELEFLEX MEDICAL NA 200931

Patients

Seq Age Sex Outcome Treatment
1 UNK