FDA Adverse Event
Injury
Summary report: N
LAERDAL AIRWAY LUBRICANT (LAL)
MDR report key: 561120
·
Received May 10, 2004
Report
- Report Number
- 9610483-2004-00004
- Event Type
- Injury
- Date Received
- May 10, 2004
- Report Date
- April 13, 2004
- Manufacturer
- LAERDAL MEDICAL A/S
- Product Code
- BSJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- ATTORNEY
Narratives
Description of Event or Problem · 1
A PT CLAIMS TO HAVE INCURRED ALLEGED DEBILITATING INJURY FOLLOWING AN ALLEGED PHYSICAL REACTION UPON ALLEGED "EXPOSURE" TO LAERDAL AIRWAY LUBRICANT (LAL) THAT WAS SPRAYED ONTO THE NASAL TUBE DURING THE TRAINING SCENARIO. IT WAS DETERMINED THE CO2 POWERED GLYCEROL LAL, ITEM# 071400, MAY HAVE BEEN THE PRODUCT IN USE AT THE TIME OF THE ALLEGED INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LAERDAL AIRWAY LUBRICANT (LAL) | SPRAY LUBRICANT | BSJ | LAERDAL MEDICAL A/S | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN |