BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RUSCH MIR COND FIBER OPTIC LARYN KIT

    MDR report key: 4460512 · Received January 26, 2015

    Report

    Report Number
    1044475-2015-00037
    Event Type
    Malfunction
    Date Received
    January 26, 2015
    Date of Event
    January 8, 2014
    Report Date
    January 9, 2014
    Product Code
    OGH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). THE DEVICE SAMPLE WAS NOT RETURNED FOR EVAL AT THE TIME OF THIS REPORT.

    Description of Event or Problem · 1

    THE CUSTOMER ALLEGES THAT THE MILLER 2 BLADE IS NO LONGER MAKING A CONNECTION TO LIGHT UP THE PIPE. NO PT INJURY OR CONSEQUENCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    59135 RUSCH MIR COND FIBER OPTIC LARYN KIT LARYNGOSCOPE KIT OGH 131401

    Patients

    Seq Age Sex Outcome Treatment
    1