BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HUDSON NASAL CANNULA CPAP SET, INFANT, SIZE 4

    MDR report key: 2061012 · Received March 14, 2011

    Report

    Report Number
    3004365956-2011-00099
    Event Type
    Malfunction
    Date Received
    March 14, 2011
    Report Date
    February 22, 2011
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    BZD
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE IS NOT AVAILABLE FOR EVAL BY MFR. THE LOT NUMBER IS UNK, THEREFORE, A DEVICE HISTORY RECORD (DHR) REVIEW COULD NOT BE PERFORMED. IF SAMPLE BECOMES AVAILABLE OR IF ADD'L INFO IS RECEIVED, A F/U REPORT WILL BE SUBMITTED. EVAL, CONCLUSIONS: DEVICE NOT RETURNED. NO EVAL WILL BE PERFORMED.

    Description of Event or Problem · 1

    THE EVENT IS REPORTED AS: THE ELBOWS ARE CRACKING OR BREAKING WHEN THE CUSTOMER IS TRYING TO PUT THEM IN THE (B)(4) CIRCUIT. ISSUE WAS DISCOVERED PRIOR TO USE ON A PT DURING INSPECTION/FUNCTIONALITY TESTING. NO INJURIES REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HUDSON NASAL CANNULA CPAP SET, INFANT, SIZE 4 INFANT NASAL CANNULA BZD TELEFLEX MEDICAL NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1