BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DIC TRACH TUBE

    MDR report key: 665151 · Received September 16, 2005

    Report

    Report Number
    1217052-2005-00087
    Event Type
    Malfunction
    Date Received
    September 16, 2005
    Report Date
    August 12, 2005
    Manufacturer
    SMITHS MEDICAL ASD, INC.
    Product Code
    BTO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    WHEN USING THE INNER CANNULA, AND PULLING THE TAB, THE TAB BROKE OFF AND WENT INTO THE PT. NO ADVERSE OUTCOME REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DIC TRACH TUBE TRACHEOSTOMY TUBE BTO SMITHS MEDICAL ASD, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO