BEUDAMED
    FDA Adverse Event Summary report: N

    GLIDESCOPE

    MDR report key: 2531167 · Received March 29, 2012

    Report

    Report Number
    2531167
    Date Received
    March 29, 2012
    Date of Event
    March 23, 2012
    Report Date
    March 29, 2012
    Manufacturer
    VERATHON INCORPORATED
    Product Code
    CCW
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    AN EDENTULOUS PATIENT UNDERGOING INTUBATION HAD THE TIP OF THE GLIDESCOPE BLADE BREAK OFF DURING THE PROCEDURE. THE BROKEN PIECE WAS SUCCESSFULLY RETRIEVED WITH FORCEPS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GLIDESCOPE LARYNGOSCOPE CCW VERATHON INCORPORATED PV111827 *

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR