BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ADULT AIRWAY TRAY

    MDR report key: 20773599 · Received November 25, 2024

    Report

    Report Number
    1423395-2024-00503
    Event Type
    Malfunction
    Date Received
    November 25, 2024
    Date of Event
    November 7, 2024
    Report Date
    November 25, 2024
    Manufacturer
    MEDLINE INDUSTRIES, LP
    Product Code
    CAI
    UDI-DI
    40195327356935
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    DE, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 0

    ACCORDING TO THE FACILITY ON (B)(6) 2024 "PATIENT NEEDED TO BE INTUBATED, RESPIRATORY THERAPIST OBTAINED SEALED AIRWAY BOX FROM RAPID RESPONSE TEAM CART AND RESPIRATORY THERAPIST NOTED THAT AIRWAY BOX WAS MISSING BOTH 7.5 AND 8.0 ENDOTRACHEAL TUBES FROM BOX". PER THE FACILITY THE PATIENT WAS NOT INJURED AND DID NOT REQUIRE MEDICAL INTERVENTION. THE SAMPLE IS NOT AVAILABLE FOR EVALUATION. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. IT HAS BEEN DETERMINED THAT THE REPORTED EVENT COULD CAUSE OR CONTRIBUTE TO SERIOUS INJURY IF IT WERE TO OCCUR. IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED OR OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.

    Description of Event or Problem · 0

    ACCORDING TO THE FACILITY ON (B)(6) 2024 "PATIENT NEEDED TO BE INTUBATED, RESPIRATORY THERAPIST OBTAINED SEALED AIRWAY BOX FROM RAPID RESPONSE TEAM CART AND RESPIRATORY THERAPIST NOTED THAT AIRWAY BOX WAS MISSING BOTH 7.5 AND 8.0 ENDOTRACHEAL TUBES FROM BOX".

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1631476 ADULT AIRWAY TRAY CAI MEDLINE INDUSTRIES, LP 24EDA505 40195327356935

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Unknown