MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2000-09-05 for MICRO TIP WIPE 3300 * manufactured by Devon Industries Inc.
[149299]
The pt had problems with obstruction after a tonsillectomy and adenoidectomy were performed. Pt was returned to o. R. Where they were scoped. A microtip wipe was found in the trachea. Using grasping forceps, the foreign body was removed. The pt returned to the recovery room in satisfactory condition.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 294902 |
| MDR Report Key | 294902 |
| Date Received | 2000-09-05 |
| Date of Report | 2000-09-01 |
| Date of Event | 2000-03-24 |
| Date Facility Aware | 2000-03-25 |
| Report Date | 2000-09-01 |
| Date Reported to FDA | 2000-09-01 |
| Date Added to Maude | 2000-09-12 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MICRO TIP WIPE |
| Generic Name | WIPE |
| Product Code | LRQ |
| Date Received | 2000-09-05 |
| Model Number | 3300 |
| Catalog Number | * |
| Lot Number | 9279032 |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | * |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 285436 |
| Manufacturer | DEVON INDUSTRIES INC |
| Manufacturer Address | 9530 DESOTO AVE CHATSWORTH CA 91311 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2000-09-05 |