BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AMBU-ADULT SINGLE PT USE

    MDR report key: 309054 · Received December 15, 2000

    Report

    Report Number
    MW1020622
    Event Type
    Injury
    Date Received
    December 15, 2000
    Date of Event
    November 9, 2000
    Report Date
    December 5, 2000
    Manufacturer
    AMBU-INC
    Product Code
    BTM
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RESERVOIR WOULD NOT FILL WITH OXYGEN UNABLE TO VENTILATE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMBU-ADULT SINGLE PT USE RESUSCITATOR (SPUR) BAG WITH MASK BTM AMBU-INC * *

    Patients

    Seq Age Sex Outcome Treatment
    1 28 YR Required Intervention