BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NASOPHARYNGEAL AIRWAY

    MDR report key: 2218171 · Received August 12, 2011

    Report

    Report Number
    1036445-2011-00159
    Event Type
    Injury
    Date Received
    August 12, 2011
    Report Date
    August 12, 2011
    Manufacturer
    WELL LEAD MEDICAL CO. LTD
    Product Code
    BTQ
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    MO, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    ON THREE OCCASIONS, TUBING SEPARATED FROM THE AIRWAY AND THE TUBING LODGED IN THE INFANT'S THROAT. ADDITIONAL INFO HAS BEEN REQUESTED MULTIPLE TIMES, BUT WAS NOT AVAILABLE AS OF THE DATE OF THIS REPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NASOPHARYNGEAL AIRWAY BTQ WELL LEAD MEDICAL CO. LTD

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention