BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HY-TAPE

    MDR report key: 20332645 · Received September 30, 2024

    Report

    Report Number
    20332645
    Event Type
    Malfunction
    Date Received
    September 30, 2024
    Date of Event
    May 4, 2024
    Report Date
    June 17, 2024
    Manufacturer
    HY-TAPE INTERNATIONAL, INC.
    Product Code
    KGX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    OH
    Reporter Occupation
    RISK MANAGER
    Health Professional
    N

    Narratives

    Description of Event or Problem · 0

    HEALTHCARE PROVIDER FOUND ENDOTRACHEAL TUBE HAD SLIPPED THROUGH TAPE FROM 6CM AT THE LIP TO 5CM AT THE LIP. HEALTHCARE PROVIDER WAS ABLE TO SLIP IT RIGHT BACK THROUGH THE TAPE TO 6CM AT THE LIP. WE GRABBED A FRESH ROLL OF TAPE AND RE-TAPED THE TUBE AT 6CM AT THE LIP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2603542 HY-TAPE TAPE AND BANDAGE, ADHESIVE KGX HY-TAPE INTERNATIONAL, INC. 7656107

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown