BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BRONCHO-CATH 41 FR LEFT SIDED ENDOBRONCHIAL TUBE

    MDR report key: 810709 · Received January 26, 2007

    Report

    Report Number
    MW1041760
    Event Type
    Injury
    Date Received
    January 26, 2007
    Date of Event
    January 5, 2007
    Report Date
    January 26, 2007
    Manufacturer
    MALLINCKRODT
    Product Code
    CBI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    AFTER PLACEMENT OF DLT ENDOBRONCHIAL TUBE, ELECTIVE FOB PERFORMED AND A 1 X 2 MM CLEAR PLASTIC WITH BLUE LINE FOREIGN BODY WAS NOTED SITTING ON CARINA. AFTER CONFIRMING PROPER PLACEMENT OF LEFT SIDED ENDOBRONCHIAL CUFF IN LEFT MAIN STEM, FOB RETRIEVAL OF FOREIGN BODY BY MEANS OF FOB SUCTION BY DOCTOR WAS PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BRONCHO-CATH 41 FR LEFT SIDED ENDOBRONCHIAL TUBE * CBI MALLINCKRODT * 2005025744

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Disability