FDA Adverse Event Malfunction Summary report: N

LMA FLEXIBLE, REU, SIZE 5

MDR report key: 3820854 · Received April 15, 2014

Report

Report Number
9681900-2014-00016
Event Type
Malfunction
Date Received
April 15, 2014
Date of Event
April 9, 2014
Report Date
April 9, 2014
Manufacturer
TELEFLEX ASIA PTE LTD
Product Code
CAE
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CUSTOMER ALLEGES THAT THERE WAS A SMALL PIN HOLE OBSERVED AT THE BASE OF THE CUFF. THE CUFF FAILED TO MAINTAIN INFLATION. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
230483 LMA FLEXIBLE, REU, SIZE 5 LARYNGEAL MASK AIRWAY CAE TELEFLEX ASIA PTE LTD

Patients

Seq Age Sex Outcome Treatment
1