BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNIVERSAL BITE BLOCK

    MDR report key: 9245094 · Received October 25, 2019

    Report

    Report Number
    MW5090706
    Event Type
    Injury
    Date Received
    October 25, 2019
    Date of Event
    July 30, 2019
    Report Date
    October 9, 2019
    Manufacturer
    B&B MEDICAL TECHNOLOGIES, INC.
    Product Code
    JAY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BITE BLOCK LOOKS COVER LOST IN ESOPHAGUS DURING INTUBATION ATTEMPT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1032461 UNIVERSAL BITE BLOCK SUPPORT, BREATHING TUBE JAY B&B MEDICAL TECHNOLOGIES, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 34 YR Required Intervention