BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AIRWAY #4

    MDR report key: 31107 · Received March 12, 1996

    Report

    Report Number
    MW1008583
    Event Type
    Malfunction
    Date Received
    March 12, 1996
    Manufacturer
    LARYNGEAL MASK CO. GENSIA, INC.
    Product Code
    CAE
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHILE FLEXING TUBE PRIOR TO INSERTION, THE TUBE BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AIRWAY #4 AIRWAY CAE LARYNGEAL MASK CO. GENSIA, INC. AS 446154514

    Patients

    Seq Age Sex Outcome Treatment
    1 *