FDA Adverse Event Injury Summary report: N

NEOTECH NEOBAR

MDR report key: 3760821 · Received April 9, 2014

Report

Report Number
2025917-2014-00010
Event Type
Injury
Date Received
April 9, 2014
Date of Event
June 21, 2012
Report Date
August 16, 2012
Manufacturer
NEOTECH PRODUCTS, INC.
Product Code
CBH
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED WAS NOT RETURNED TO THE MANUFACTURER AS IT WAS DISPOSED OF BY THE FACILITY. THE DIRECTIONS FOR USE WERE NOT BEING FOLLOWED BY THE STAFF AT THE TIME OF THE EVENT. NO INVESTIGATION WAS PERFORMED, AS THIS IS A KNOWN ISSUE WITH NEOBARS MANUFACTURED ON THIS DATE. DUE TO CONCERNS OF THE NEOBARS DISLODGING FROM THE ADHESIVE TABS, THE MANUFACTURING OF ALL NEOBARS HAS SINCE CHANGED TO INCLUDE A WELDING PROCEDURE AND NO REPORTS OF TAB SEPARATION HAVE BEEN REPORTED TO THIS DAY. THIS IS THE FINAL REPORT.

Description of Event or Problem · 1

A REPORT WAS RECEIVED THAT THE PLASTIC BAR OF THE ET TUBE HOLDER BECAME SEPARATED FROM THE ADHESIVE TAB AFTER 9 DAYS OF USE, WHICH IS BEYOND THE RECOMMENDED TIME FRAME OF USE (5-7 DAYS). THIS OCCURRED WHILE THE NURSE WAS REPOSITIONING THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
212934 NEOTECH NEOBAR ET TUBE HOLDER CBH NEOTECH PRODUCTS, INC. N713 508-12

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention ET TUBE WAS BEING USED WITH THE NEOBAR