MAUDE MDR 2889104

MDR report key
2889104
Report number
3003898360-2012-00614
Event key
0
Event type
3
Date of event
2012-12-07
Date received
2012-12-21
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
KATHARINE TARPLEY
Address
P. O. BOX 12600 RTP NC 27709 US
Phone
919-919-9194
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HUDSON ENDOTRACHEAL TUBE, HVT, 7.0, NOVA PLUSET TUBETELEFLEXLNZV5-1031401F1200189R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-12-210

Event Narratives#

D

Patient 1

THE COMPLAINT IS REPORTED AS: THE CUFF ON THE TUBE IS DEFLATING AND CREATING LEAKS DURING PATIENT USE. THE CUFF HAD TO BE REINFLATED AND MONITORED. NO PATIENT INJURY REPORTED.

N

Patient 1

THE DEVICE HISTORY RECORD (DHR) REVIEW WAS PERFORMED AND THERE WERE NO ISSUES FOUND THAT COULD RELATE TO THE REPORTED COMPLAINT. THE DEVICE SAMPLE IS NOT AVAILABLE FOR EVALUATION, THEREFORE, THE COMPLAINT COULD NOT BE CONFIRMED AND A ROOT CAUSE COULD NOT BE ESTABLISHED. MANUFACTURER WILL CONTINUE TO MONITOR AND TREND RELATED COMPLAINTS.