FDA Adverse Event Malfunction Summary report: N

HUDSON SPIRAL-FLEX ET TUBE 7.0

MDR report key: 1993686 · Received January 6, 2011

Report

Report Number
3003898360-2011-00015
Event Type
Malfunction
Date Received
January 6, 2011
Report Date
December 9, 2010
Manufacturer
TELEFLEX MEDICAL
Product Code
BTR
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT WAS NOT RECEIVED BY MFR FOR EVAL AT THIS TIME. INVESTIGATION REPORT IS INCOMPLETE AT THIS TIME. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: IT WAS NOTICED WHEN THE DRAPES WERE REMOVED THAT THE PILOT BALLOON WAS DETACHED. THE PT HAD TO BE REINTUBATED. NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON SPIRAL-FLEX ET TUBE 7.0 SPIRAL-FLEX ET TUBE BTR TELEFLEX MEDICAL NA UNK

Patients

Seq Age Sex Outcome Treatment
1