MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2010-06-17 for HOSPIRA LTA 360 4698-01 0409-4698-01 manufactured by Hospira.
[15560245]
During intubation and use of lta, approximately 3" of lta snapped off and entered patient's right bronchus.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5016438 |
| MDR Report Key | 1732871 |
| Date Received | 2010-06-17 |
| Date of Report | 2010-06-17 |
| Date Added to Maude | 2010-06-24 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | HOSPIRA LTA 360 |
| Generic Name | LTA LARYNGOTRACHEAL ANESTH KIT PRE ATTACHED |
| Product Code | CCT |
| Date Received | 2010-06-17 |
| Model Number | 4698-01 |
| Catalog Number | 0409-4698-01 |
| Lot Number | 000000000000000 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | HOSPIRA |
| Manufacturer Address | LAKE FOREST IL US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2010-06-17 |