FDA Adverse Event Injury Summary report: N

SHILEY

MDR report key: 3060305 · Received April 11, 2013

Report

Report Number
2936999-2013-00277
Event Type
Injury
Date Received
April 11, 2013
Date of Event
March 13, 2013
Report Date
March 15, 2013
Manufacturer
COVIDIEN / FORMERLY TYCOHEA.
Product Code
JOH
PMA / PMN Number
K945513
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO SAMPLE AVAILABLE FOR ANALYSIS. INFORMATION HAS BEEN ADDED TO THE DATABASE FOR TRENDING PURPOSES.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE CURVE OF THE CANNULA WAS INCORRECT, SO THEY COULD NOT INTRODUCE IT IN THE PATIENT. THE END USER USED AN OTHER CANNULA. THE INFORMATION TO DATE SUGGEST THAT THE ISSUE WAS IDENTIFIED PRIOR TO PATIENT USE. COVIDIEN IS ATTEMPTING TO COLLECT FURTHER DETAILS RELATED TO THIS REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
154303 SHILEY PEDIATRIC TRACH TUBE JOH COVIDIEN / FORMERLY TYCOHEA. 120300598X

Patients

Seq Age Sex Outcome Treatment
1