FDA Adverse Event Malfunction Summary report: N

HUDSON ENDOTRACHEAL TUBE, HVT, 7.0, NOVA PLUS

MDR report key: 3063608 · Received April 12, 2013

Report

Report Number
3003898360-2013-00133
Event Type
Malfunction
Date Received
April 12, 2013
Date of Event
March 18, 2013
Report Date
March 25, 2013
Manufacturer
TELEFLEX
Product Code
BTR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY RECORD (DHR) REVIEW WAS PERFORMED AND THERE WERE NO ISSUES FOUND THAT COULD RELATE TO THE REPORTED COMPLAINT. THE SAMPLE WAS NOT RETURNED FOR EVALUATION, THEREFORE, THE COMPLAINT COULD NOT BE CONFIRMED.

Description of Event or Problem · 1

THE COMPLAINT IS REPORTED AS: DURING VENTILATION ON A PATIENT THE HUB DISCONNECTED FROM THE ET TUBE AND WOULDN'T STAY IN PLACE. IT HAD TO BE TAPED DOWN. NO PT INJURY REPORTED. PT CONDITION IS LISTED AS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
157069 HUDSON ENDOTRACHEAL TUBE, HVT, 7.0, NOVA PLUS ET TUBE BTR TELEFLEX 01H1200169

Patients

Seq Age Sex Outcome Treatment
1