BEUDAMED
    FDA Adverse Event Death Summary report: N

    *

    MDR report key: 829750 · Received March 20, 2007

    Report

    Report Number
    MW1042251
    Event Type
    Death
    Date Received
    March 20, 2007
    Date of Event
    March 19, 2007
    Report Date
    March 19, 2007
    Manufacturer
    GREENLINE
    Product Code
    CCW
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    PARAMEDIC

    Narratives

    Description of Event or Problem · 1

    ATTEMPTED INTUBATION AND THE LIGHT WAS NOT WORKING. THE SOURCE LIGHT ON THE FIBEROPTIC HANDLE WOULD NOT LIGHT UP. BATTERIES WERE FRESH, HANDLE AND BLADE WERE INSPECTED AT THE START OF SHIFT AND WERE WORKING APPROPRIATELY. FAILURE OF THE DEVICE PROLONGED SECURING AN ADVANCED AIRWAY IN THE PT BY APPROX 2 MINUTES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * LARYNGOSCOPE BLADE CCW GREENLINE * *
    2 * LARYNGOSCOPE HANDLE CCW GREENLINE * *

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Death