FDA Adverse Event Malfunction Summary report: N

RUSCH ENDOBRONCHIAL TUBE, CARINA HOOK, 35F

MDR report key: 2092913 · Received April 11, 2011

Report

Report Number
1044475-2011-00043
Event Type
Malfunction
Date Received
April 11, 2011
Date of Event
March 16, 2011
Report Date
March 22, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
BTR
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT HAS NOT YET BEEN RECEIVED BY MFR, THEREFORE, INVESTIGATION REPORT IS INCOMPLETE AT THIS TIME. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE WHITE BALLOON WAS LEAKING DURING FUNCTIONALITY TESTING. DEFECT WAS DISCOVERED PRIOR TO USE ON A PT DURING INSPECTION / FUNCTIONALITY TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RUSCH ENDOBRONCHIAL TUBE, CARINA HOOK, 35F ENDOBRONCHIAL TUBE BTR TELEFLEX MEDICAL NA 0716001

Patients

Seq Age Sex Outcome Treatment
1