BEUDAMED
    FDA Adverse Event Death Summary report: N

    KING LTS-D LARYNGEAL TUBE

    MDR report key: 8617025 · Received May 3, 2019

    Report

    Report Number
    8617025
    Event Type
    Death
    Date Received
    May 3, 2019
    Date of Event
    March 5, 2019
    Report Date
    May 3, 2019
    Manufacturer
    AMBU INC.
    Product Code
    CAE
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US
    Reporter Occupation
    501

    Narratives

    Description of Event or Problem · 1

    MEDICA CREW INITIALLY ATTEMPTED INTUBATION WHICH WAS UNSUCCESSFUL, THIS WAS FOLLOWED WITH AIRWAY MANAGEMENT USING A KING LARYNGEAL TUBE. AFTER INSERTION OF THE KING AIRWAY, THE TUBE BROKE AT THE HUB WHERE THE BAG-VALVE MASK WOULD HAVE ATTACHED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    371702 KING LTS-D LARYNGEAL TUBE KING AIRWAY CAE AMBU INC. KLTSD431

    Patients

    Seq Age Sex Outcome Treatment
    0 Death