BEUDAMED
    FDA Adverse Event Death Summary report: N

    KING LT AIRWAY

    MDR report key: 2281443 · Received October 4, 2011

    Report

    Report Number
    MW5022492
    Event Type
    Death
    Date Received
    October 4, 2011
    Date of Event
    August 1, 2011
    Report Date
    September 28, 2011
    Manufacturer
    KING SYSTEMS CORP.
    Product Code
    CAE
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    KING LT TUBE FOUND BENT IN GLOTTIS AT AUTOPSY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KING LT AIRWAY KING LT AIRWAY CAE KING SYSTEMS CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR Death| L