FDA Adverse Event
Malfunction
Summary report: N
SHILEY SINGLE CANNULA CUFFED TRACHEOSTOMY TUBE
MDR report key: 408270
·
Received July 29, 2002
Report
- Report Number
- 2029387-2002-00066
- Event Type
- Malfunction
- Date Received
- July 29, 2002
- Report Date
- July 29, 2002
- Manufacturer
- NELLCOR PURITAN BENNETT, INC./MALLINCKRODT, INC.
- Product Code
- JOH
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
CUSTOMER STATES THAT A BALLARD IN-LINE SUCTION DEVICE IS "POPPING OFF" OF THE 15MM CONNECTOR OF THE "SCT".
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | SHILEY SINGLE CANNULA CUFFED TRACHEOSTOMY TUBE | TRACHEOSTOMY TUBE | JOH | NELLCOR PURITAN BENNETT, INC./MALLINCKRODT, INC. | 6SCT | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NO INFO |