FDA Adverse Event Malfunction Summary report: N

RUSCH RI FIBER-OPTIC LARYNGOSCOPE KIT

MDR report key: 4188203 · Received October 16, 2014

Report

Report Number
1044475-2014-00285
Event Type
Malfunction
Date Received
October 16, 2014
Date of Event
September 26, 2014
Report Date
September 29, 2014
Manufacturer
TELEFLEX
Product Code
OGH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A DEVICE HISTORY RECORD (DHR) REVIEW COULD NOT BE PERFORMED AS THE LOT NUMBER WAS UNKNOWN. THE SAMPLE WAS NOT RETURNED FOR EVALUATION, THEREFORE, THE COMPLAINT COULD NOT BE CONFIRMED. IF THE SAMPLE IS RECEIVED, A FOLLOW-UP REPORT WILL BE SUBMITTED WITH INVESTIGATION RESULTS.

Description of Event or Problem · 1

THE COMPLAINT ALLEGES THAT THE HANDLE STOPPED WORKING. THERE WERE NO REPORTS OF PATIENTS HARM OR INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
656617 RUSCH RI FIBER-OPTIC LARYNGOSCOPE KIT MRI LARYNGOSCOPE KIT OGH TELEFLEX

Patients

Seq Age Sex Outcome Treatment
1