FDA Adverse Event Injury Summary report: N

OMNIGUIDE BEAMPATH ENT-L

MDR report key: 2624151 · Received September 3, 2009

Report

Report Number
3005350457-2009-00003
Event Type
Injury
Date Received
September 3, 2009
Date of Event
August 3, 2009
Report Date
September 2, 2009
Manufacturer
OMNIGUIDE, INC.
Product Code
GEX
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE PATIENT WAS BEING TREATED FOR REMOVAL OF A TRACHEAL GRANULOMA. DURING THE PROCEDURE THE PHYSICIAN FIRED THE LASER HITTING THE TRACHEAL TUBE CUFF (BALLOON) CAUSING IT TO IGNITE. PER THE PHYSICIAN THE OXYGEN LEVELS WERE AT OR BELOW 30% DURING THE CASE, WHICH ARE THE RECOMMENDED LEVELS. SUBSEQUENT TO THE CASE THE LASER WAS EVALUATED BY THE HOSPITAL BIOMET AND FOUND TO BE PERFORMING TO ITS SPECIFICATION. THERE WAS NO INDICATION THAT THE FIBER MALFUNCTIONED AND IT WAS NOT RETURNED FOR EVALUATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OMNIGUIDE BEAMPATH ENT-L CO2 WAVEGUIDE FIBER GEX OMNIGUIDE, INC. ENT-L NA

Patients

Seq Age Sex Outcome Treatment
1