BEUDAMED
    FDA Adverse Event Death Summary report: N

    WELCH ALLYN

    MDR report key: 639943 · Received October 4, 2005

    Report

    Report Number
    1619634-2005-00001
    Event Type
    Death
    Date Received
    October 4, 2005
    Date of Event
    September 15, 2005
    Report Date
    October 4, 2005
    Manufacturer
    WELCH ALLYN INC.
    Product Code
    EQN
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    NC, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DOCTOR TRIED TO INTUBATE A PATIENT WHO COLLAPSED IN A PARKING LOT. LIGHT IN LARYNGOSCOPE WOULD NOT STAY ON DUE TO FAILURE OF CAP WHICH HOLDS LIGHT SOURCE IN PLACE. DOCTOR WAS UNABLE TO INTUBATE AND PATIENT DIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WELCH ALLYN 3 1/2" DISPOSABLE MACINTOSH LARYNGOSCOPE EQN WELCH ALLYN INC. 56903 *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Death