FDA Adverse Event
Injury
Summary report: N
CURITY
MDR report key: 7537009
·
Received May 23, 2018
Report
- Report Number
- 8040459-2018-00051
- Event Type
- Injury
- Date Received
- May 23, 2018
- Report Date
- May 23, 2018
- Manufacturer
- KENDALL GAMMATRON, THAILAND
- Product Code
- BTR
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FR
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
THIS PRODUCT IS NOT SOLD IN US AND IS 510(K) EXEMPT. THIS REPORT IS ASSOCIATED TO A SIMILAR PRODUCT SOLD IN THE US WITH 510(K) NUMBER K892432. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.
Description of Event or Problem · 1
ACCORDING TO THE REPORTER, DURING THE PROCEDURE, THE FIRST BALLOON, DEFLATED WHICH CAUSED PATIENT TO BE EXTUBATED. ON THE OTHER HAND, THE SECOND BALLOON CONSTANTLY INFLATE. THE CUSTOMER REPORTED THAT THE PATIENT STATUS WAS UNKNOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 381677 | CURITY | TUBE, TRACHEAL (W/WO CONNECTOR) | BTR | KENDALL GAMMATRON, THAILAND | 9475E |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |