FDA Adverse Event Injury Summary report: N

CURITY

MDR report key: 8978479 · Received September 10, 2019

Report

Report Number
8040459-2019-00099
Event Type
Injury
Date Received
September 10, 2019
Date of Event
August 2, 2019
Report Date
September 10, 2019
Manufacturer
KENDALL GAMMATRON, THAILAND
Product Code
BTR
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
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, IN ORDER TO RESCUE A PATIENT FROM PESTICIDE POISONING,THE DOCTOR'S ADVICE FOR TRACHEAL INTUBATION ASSISTED BREATHING, AFTER THE TRACHEAL INTUBATION WAS INSERTED, THE AIR BAG WAS FOUND TO BE LEAKING AND ANOTHER NEW ONE WAS REPLACED AND USED ON THE PATIENT. RE-INTUBATION WAS REQUIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
773545 CURITY TUBE, TRACHEAL (W/WO CONNECTOR) BTR KENDALL GAMMATRON, THAILAND 9475E 1835452FED

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention