FDA Adverse Event Injury Summary report: N

ANCHOR FAST

MDR report key: 3874225 · Received June 11, 2014

Report

Report Number
MW5036604
Event Type
Injury
Date Received
June 11, 2014
Date of Event
April 7, 2014
Report Date
June 10, 2014
Manufacturer
HOLLISTER
Product Code
CBH
Product Problem
Yes
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PATIENT HAD A BREAK DOWN ON HIS LIP LIKELY ATTRIBUTABLE TO THE ENDOTRACHEAL TUBE SECURING DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
343871 ANCHOR FAST ETT SECURING DEVICE CBH HOLLISTER

Patients

Seq Age Sex Outcome Treatment
1 82 YR Required Intervention