BEUDAMED
    FDA Adverse Event Other Summary report: N

    HOLLISTER ETAD

    MDR report key: 517745 · Received March 24, 2004

    Report

    Report Number
    1119193-2004-00001
    Event Type
    Other
    Date Received
    March 24, 2004
    Report Date
    March 18, 2004
    Manufacturer
    HOLLISTER INCORPORATED
    Product Code
    CBH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A PRESSURE SORE IN THE AREA BETWEEN THE PT'S NOSE AND THE LIP DEVELOPED THAT WILL REQUIRE PLASTIC SURGERY TO CLOSE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOLLISTER ETAD ENDOTRACHEAL TUBE ATTACHMENT DEVICE CBH HOLLISTER INCORPORATED NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention