FDA Adverse Event Other Summary report: N

AMBU NEUROLINE 720

MDR report key: 2474076 · Received February 24, 2012

Report

Report Number
9610691-2012-00001
Event Type
Other
Date Received
February 24, 2012
Report Date
February 14, 2012
Manufacturer
AMBU A/S
Product Code
GXY
PMA / PMN Number
K970639
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

BACKING OF ELECTRODE WAS ACCIDENTLY LEFT IN A BABY'S CRIB AND THE BABY PUT THE PLASTIC BACKING IN HIS MOUTH AND CHOKED ON IT. THE NEUROLINE ELECTRODES ARE FOR PROFESSIONAL USERS ONLY.

Description of Event or Problem · 1

CUSTOMER WROTE: BACKING OF ELECTRODE IS A OPAQUE/WHITE PLASTIC. APPARENTLY ONE WAS ACCIDENTLY LEFT IN A BABY'S CRIB AND THE BABY PUT THE PLASTIC BACKING IN HIS MOUTH AND CHOKED ON IT. THE NURSE WAS ABLE TO REMOVE THE ITEM. PT WAS NOT HARMED. PT CONDITION WAS NOT AFFECTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AMBU NEUROLINE 720 SINGLE PATIENT SURFACE ELECTRODE GXY AMBU A/S AMBU NEUROLINE 720 1359475

Patients

Seq Age Sex Outcome Treatment
1 Other