BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FOCS MACINTOSH 4 BLADE

    MDR report key: 429301 · Received November 21, 2002

    Report

    Report Number
    2429473-2002-00215
    Event Type
    Malfunction
    Date Received
    November 21, 2002
    Report Date
    November 13, 2002
    Manufacturer
    RUSCH INC.
    Product Code
    CAL
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CUSTOMER REPORTS THAT BLADE BROKE OFF IN PT'S MOUTH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOCS MACINTOSH 4 BLADE ANESTHESIA - LARYNGOSCOPE CAL RUSCH INC. NA 116587

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN