FDA Adverse Event
Malfunction
Summary report: N
PORTEX CUFFED TRACHEOSTOMY TUBE
MDR report key: 2000013
·
Received February 17, 2011
Report
- Report Number
- 2183502-2011-00036
- Event Type
- Malfunction
- Date Received
- February 17, 2011
- Date of Event
- January 1, 2011
- Report Date
- February 15, 2011
- Manufacturer
- SMITHS MEDICAL INTERNATIONAL, LTD.
- Product Code
- BTO
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.
Description of Event or Problem · 1
A REPORT WAS RECEIVED THAT ALLEGES THAT THE TRACHEOSTOMY TUBE WAS DEFLATING AT THE CUFF AFTER SEVERAL DAYS IN SITU. REPLACEMENT WAS REQUIRED. NO INCIDENT RELATED MEDICAL SEQUELA WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PORTEX CUFFED TRACHEOSTOMY TUBE | BTO - TRACHEOSTOMY TUBES | BTO | SMITHS MEDICAL INTERNATIONAL, LTD. | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |