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 |