FDA Adverse Event
Malfunction
Summary report: N
5.0MM HI LO
MDR report key: 241344
·
Received September 17, 1999
Report
- Report Number
- 9681384-1999-00026
- Event Type
- Malfunction
- Date Received
- September 17, 1999
- Date of Event
- August 10, 1999
- Report Date
- September 10, 1999
- Manufacturer
- MMJ SA DE CV
- Product Code
- BTR
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NJ, US
- Reporter Occupation
- RESPIRATORY THERAPIST
Narratives
Description of Event or Problem · 1
THE FACILITY REPORTED: "THREE DIFFERENT TUBES FAILED ON THREE DIFFERENT PTS IN ONE DAY. THE FACILITY IS UNSURE OF THE ACTUAL SIZES OR LOT NUMBERS OF THE TUBES INVOLVED." FACILITY SUBMITTED THE FOLLOWING LIST OF SUSPECTED LOT NUMBERS, M024860, M030650, M043600, M030150, M032960, M041440, M041420, M031040, M015530.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | 5.0MM HI LO | ENDOTRACHEAL TUBE | BTR | MMJ SA DE CV | NA | M043600 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NO INFO |