FDA Adverse Event Malfunction Summary report: N

PORTEX 7.0MM SUCTIONAID TRACHEOSTOMY TUBE

MDR report key: 3012704 · Received February 22, 2013

Report

Report Number
2183502-2013-00047
Event Type
Malfunction
Date Received
February 22, 2013
Date of Event
January 22, 2013
Report Date
February 21, 2013
Manufacturer
SMITHS MEDICAL INTERNATIONAL LTD
Product Code
CAZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MFR FOR DEVICE EVAL. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MFR WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVAL.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT ALLEGES THAT THE TRACHEOSTOMY TUBE WAS DEFLATING AT THE CUFF AFTER 5 HOURS SITU. REPLACEMENT WAS REQUIRED. NO INCIDENT RELATED MEDICAL SEQUELA WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
78825 PORTEX 7.0MM SUCTIONAID TRACHEOSTOMY TUBE TRACHEOSTOMY TUBES CAZ SMITHS MEDICAL INTERNATIONAL LTD NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK