FDA Adverse Event Malfunction Summary report: N

PORTEX BLUE LINE SACETT SUCTION ABOVE THE CUFF TRACHEAL TUBE

MDR report key: 2030338 · Received March 21, 2011

Report

Report Number
2183502-2011-00086
Event Type
Malfunction
Date Received
March 21, 2011
Date of Event
February 14, 2011
Report Date
March 14, 2011
Manufacturer
SMITHS MEDICAL INTERNATIONAL LTD.
Product Code
BTR
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 MFR FOR DEVICE EVAL. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MFR WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVAL.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT STATES THAT THE INFLATION LINE OF THE TRACHEOSTOMY TUBE LEAK AFTER 48 HOURS IN SITU. THERE WAS NO REPORT OF INCIDENT RELATED MEDICAL SEQUELAE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PORTEX BLUE LINE SACETT SUCTION ABOVE THE CUFF TRACHEAL TUBE BTR - TRACHEAL TUBES BTR SMITHS MEDICAL INTERNATIONAL LTD. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK