FDA Adverse Event Injury Summary report: N

CURITY

MDR report key: 8001962 · Received October 24, 2018

Report

Report Number
8040459-2018-00077
Event Type
Injury
Date Received
October 24, 2018
Report Date
October 24, 2018
Manufacturer
KENDALL GAMMATRON, THAILAND
Product Code
BTR
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE 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 INTUBATION OF A PATIENT THE BALLOON OF THE LOT DEFLATED 3 TIMES AND THAT THIS PROBLEM WAS THE ¿THIRD OCCURRENCE IN ABOUT TWO MONTHS¿.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
840566 CURITY TUBE, TRACHEAL (W/WO CONNECTOR) BTR KENDALL GAMMATRON, THAILAND 9475E

Patients

Seq Age Sex Outcome Treatment
1 Other