BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HUDSON CANNULA, OVER-THE-EAR NASAL TIP, 7'

    MDR report key: 2171426 · Received June 29, 2011

    Report

    Report Number
    3004365956-2011-00264
    Event Type
    Malfunction
    Date Received
    June 29, 2011
    Date of Event
    June 15, 2011
    Report Date
    June 21, 2011
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    BZD
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE SAMPLE WAS NOT RECEIVED BY THE MANUFACTURER AT THE TIME OF THIS REPORT. A FOLLOW-UP REPORT WILL BE SENT WHEN COMPLETION OF INVESTIGATION.

    Description of Event or Problem · 1

    THE EVENT IS REPORTED AS: COMPLAINT ALLEGES THAT CANNULA DOES NOT HAVE A HOLE FOR OXYGEN DELIVERY. NO PT INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HUDSON CANNULA, OVER-THE-EAR NASAL TIP, 7' CANNULA NASAL TIP BZD TELEFLEX MEDICAL NA 02C1102724

    Patients

    Seq Age Sex Outcome Treatment
    1 NA