BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MALLINCKRODT

    MDR report key: 4212215 · Received March 19, 2014

    Report

    Report Number
    2936999-2014-00256
    Event Type
    Malfunction
    Date Received
    March 19, 2014
    Date of Event
    February 14, 2014
    Report Date
    October 30, 2014
    Manufacturer
    COVIDIEN
    Product Code
    BTS
    PMA / PMN Number
    K771219
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    PHYSICIAN
    Health Professional
    N

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    165346 MALLINCKRODT ENDOBRONCHIAL TUBE LEFT/RIGHT BTS COVIDIEN 201311069X

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown