BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RUSCH CARLENS EB TUBE WITH CARINA HOOK

    MDR report key: 3013076 · Received March 15, 2013

    Report

    Report Number
    8040412-2013-00059
    Event Type
    Malfunction
    Date Received
    March 15, 2013
    Date of Event
    February 27, 2013
    Report Date
    March 1, 2013
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    BTS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FR
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    THE EVENT IS REPORTED AS: THE CONNECTOR ON THE ENDOBRONCHIAL TUBE BROKE WITHOUT ANY FORCE OR ANY MANIPULATION. NO PRE-TEST WAS CARRIED OUT. NO INTERVENTION REPORTED. NO REPORT OF PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    110696 RUSCH CARLENS EB TUBE WITH CARINA HOOK ENDOBRONCHIAL TUBE BTS TELEFLEX MEDICAL 12BE07

    Patients

    Seq Age Sex Outcome Treatment
    1