FDA Adverse Event Malfunction Summary report: N

HUDSON INCENTIVE SPIROMETER

MDR report key: 2102045 · Received April 13, 2011

Report

Report Number
3004365956-2011-00180
Event Type
Malfunction
Date Received
April 13, 2011
Date of Event
January 19, 2011
Report Date
January 20, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
BWF
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

PRODUCT HAS NOT YET BEEN RECEIVED BY MANUFACTURER, 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

COMPLAINT ALLEGES THAT UPON INSPECTION (PRIOR TO PATIENT USE), THERE WAS A LARGE QUANTITY OF SPIROMETERS WITH A BROKEN/CRACKED MOUTHPIECE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON INCENTIVE SPIROMETER SPIROMETER BWF TELEFLEX MEDICAL NA 02F1000275

Patients

Seq Age Sex Outcome Treatment
1