BEUDAMED
    FDA Adverse Event Other Summary report: N

    ADULT CIRCUIT

    MDR report key: 282758 · Received June 16, 2000

    Report

    Report Number
    2242551-2000-00012
    Event Type
    Other
    Date Received
    June 16, 2000
    Date of Event
    May 19, 2000
    Report Date
    June 16, 2000
    Manufacturer
    VITAL SIGNS, INC.
    Product Code
    CAI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ACCOUNT REPORTED THAT THE 40" TUBE HAD A HOLE IN IT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ADULT CIRCUIT ADULT BREATHING CIRCUIT CAI VITAL SIGNS, INC. A52X2314 A125

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other