BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RUSCH FOS ILS MACINTOSH BLADE, LARGE - ADULT

    MDR report key: 3181883 · Received June 17, 2013

    Report

    Report Number
    3004365956-2013-00206
    Event Type
    Malfunction
    Date Received
    June 17, 2013
    Date of Event
    May 23, 2013
    Report Date
    May 23, 2013
    Manufacturer
    TELEFLEX MEDICAL
    Product Code
    CCW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE SAMPLE WAS NOT RETURNED FOR EVAL AT THE TIME OF THIS REPORT.

    Description of Event or Problem · 1

    THE COMPLAINT WAS REPORTED AS: THE COMPLAINT ALLEGES THAT THE LAMP ON THE BLADE WOULD NOT LIGHT OUT. NO REPORT OF PT INJURY. PT CONDITION REPORTED AS FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    273276 RUSCH FOS ILS MACINTOSH BLADE, LARGE - ADULT FIBEROPTIC LARYNGOSCOPE BLADE CCW TELEFLEX MEDICAL

    Patients

    Seq Age Sex Outcome Treatment
    1