FDA Adverse Event Malfunction Summary report: N

PARKER FLEX-TIP

MDR report key: 22919520 · Received August 28, 2025

Report

Report Number
3000219639-2025-00056
Event Type
Malfunction
Date Received
August 28, 2025
Date of Event
July 2, 2025
Report Date
August 28, 2025
Manufacturer
PARKER MEDICAL
Product Code
BTR
UDI-DI
50749065011600
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE PRODUCT INVOLVED IN THE REPORT HAS NOT BEEN RETURNED FOR EVALUATION; THE ROOT CAUSE COULD NOT BE DETERMINED. A REVIEW OF THE DEVICE HISTORY RECORD IS NOT POSSIBLE AS NO LOT NUMBER WAS PROVIDED. THE DOCUMENTED UDI IS BASED ON THE STOCK/PRODUCT CODE PROVIDED BY THE REPORTER; THE UDI-PI IS NOT AVAILABLE AS NO LOT NUMBER WAS PROVIDED ALL INFORMATION REASONABLY KNOWN AS OF 28 AUG 2025 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY SUN MED HOLDINGS LLC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO SUN MED HOLDINGS LLC. SUN MED HOLDINGS LLC. HAS NO INDEPENDENT KNOWLEDGE OF THE EVENT REPORTED BUT IS RELAYING THE INFORMATION THAT WAS PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE SUN MED HOLDINGS COMPLAINT DATABASE AND IDENTIFIED AS (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN SUN MED HOLDINGS LLC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Description of Event or Problem · 0

IT WAS REPORTED: AN AIR LEAK OCCURRED AFTER INTUBATION DURING AN OPERATION, AS A RESULT THE ANESTHESIOLOGIST INJECTED AIR INTO THE CUFF SEVERAL TIMES (DURING THE OPERATION TO MAINTAIN CUFF PRESSURE). THE OPERATION WAS COMPLETED. THERE WAS NO REPORTED INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2188962 PARKER FLEX-TIP ENDOTRACHEAL TUBE, HIGH VOLUME LOW PRESSURE (PFHV), CUFFED, PARKER, 6.0MM BTR PARKER MEDICAL I-PFHV-60 UNKNOWN 50749065011600

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown