FDA Adverse Event
Other
Summary report: N
HOLLISTER ETAD
MDR report key: 479952
·
Received August 19, 2003
Report
- Report Number
- 1119193-2003-00004
- Event Type
- Other
- Date Received
- August 19, 2003
- Report Date
- August 18, 2003
- Manufacturer
- HOLLISTER, INC.
- Product Code
- CBH
- Report Source
- Manufacturer report
- Reporter Occupation
- INVALID DATA
Narratives
Description of Event or Problem · 1
PT DEVELOPED AN ULCER BETWEEN UPPER LIP AND NOSE THAT WENT THROUGH THE SKIN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HOLLISTER ETAD | ORAL ENDOTRACHEAL TUBE ATTACHMENT DEVICE | CBH | HOLLISTER, INC. | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 80 YR | Required Intervention |