FDA Adverse Event
Malfunction
Summary report: N
GLIDESCOPE GVL 4
MDR report key: 3377640
·
Received September 12, 2013
Report
- Report Number
- 9615393-2013-00223
- Event Type
- Malfunction
- Date Received
- September 12, 2013
- Date of Event
- March 19, 2012
- Report Date
- March 19, 2012
- Manufacturer
- VERATHON MEDICAL (CANADA) ULC
- Product Code
- CCW
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVAL SUMMARY: REPORTED FAILURE CONFIRMED. SAFETY ALERT NOTICE C/R 3022472-5-07-2013-0001-C ISSUED TO ALL CUSTOMERS ON 5/10/2013 TO PROVIDE ADD'L SAFETY INFO TO REMIND USERS TO CAREFULLY EXAMINE BLADES BEFORE AND AFTER EACH USE, AND PROMPTLY REPLACE ANY THAT SHOW SIGNS OF WEAR OR DAMAGE.
Description of Event or Problem · 1
THE TIP IS CHIPPED OFF.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 459396 | GLIDESCOPE GVL 4 | VIDEO LARYNGOSCOPE | CCW | VERATHON MEDICAL (CANADA) ULC | 0574-0001 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |