BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KING

    MDR report key: 5137856 · Received June 9, 2004

    Report

    Report Number
    5137856
    Event Type
    Malfunction
    Date Received
    June 9, 2004
    Date of Event
    June 3, 2004
    Report Date
    June 9, 2004
    Manufacturer
    KING SYSTEMS, CORP.
    Product Code
    CAI
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AR, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE BULB ON THIS AIRWAY WOULD NOT STAY INFLATED. FIFTEENTH USE, GUARANTEED FOR 50 USES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KING ANESTHESIOLOGY PRODUCTS CAI KING SYSTEMS, CORP. KLT104

    Patients

    Seq Age Sex Outcome Treatment
    1