FDA Adverse Event Malfunction Summary report: N

HUDSON INCENTIVE SPIROMETER LUNG/VOL EXERCISER

MDR report key: 2113816 · Received May 17, 2011

Report

Report Number
3004365956-2011-00207
Event Type
Malfunction
Date Received
May 17, 2011
Date of Event
April 14, 2011
Report Date
May 2, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
BWF
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PK
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS NOT RECEIVED BY MFR AT THE TIME OF THIS REPORT. A F/U REPORT WILL BE SENT WHEN COMPLETION OF INVESTIGATION.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: COMPLAINT ALLEGED THAT THE MOUTH PIECES ON THE SPIROMETER WERE BROKEN. THE ALLEGED DEFECT WAS DISCOVERED UPON INCOMING INSPECTION. THERE WAS NO PT INVOLVEMENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HUDSON INCENTIVE SPIROMETER LUNG/VOL EXERCISER SPIROMETER LUNG VOLUME EXERCISER BWF TELEFLEX MEDICAL NA 02J1001994

Patients

Seq Age Sex Outcome Treatment
1 NA