FDA Adverse Event Injury Summary report: N

SCOOP CATHETER

MDR report key: 2627367 · Received September 21, 2009

Report

Report Number
1721097-2009-00001
Event Type
Injury
Date Received
September 21, 2009
Date of Event
August 21, 2009
Report Date
September 21, 2009
Manufacturer
TRANSTRACHEAL SYSTEMS, INC.
Product Code
BTR
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INCIDENT IS STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

IN (B)(6) 2009, THE PT NOTICED BLOOD-TINGED MUCUS WHEN CLEANING TRACHEAL CATHETER. PT'S PHYSICIAN PERFORMED A BRONCHOSCOPY AND INFORMED PT THAT EVERYTHING WAS FINE. AT ABOUT 10 PM ON (B)(6) 2009, PT WAS TAKEN TO HOSPITAL WITH PROFUSE BLEEDING. PT DESCRIBED THE SITUATION AS A POSSIBLE RUPTURED AORTA, HOWEVER SUBSEQUENT RESEARCH PROVED IT TO BE A POSSIBLE PERFORATED INNOMINATE ARTERY. PT WAS TAKEN TO SURGERY WHERE THE PERFORATION WAS SUCCESSFULLY REPAIRED. PT HAS SINCE BEEN DISCHARGED FROM HOSPITAL AND IS AT HOME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SCOOP CATHETER NONE BTR TRANSTRACHEAL SYSTEMS, INC. SCOOP CATHETER UNK

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention