LASER-SHIELD II ENDOTRACHEAL TUBE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-09-10 for LASER-SHIELD II ENDOTRACHEAL TUBE manufactured by Medtronic Xomed.

Event Text Entries

[25891925] On (b)(6) 2015, patient underwent transoral sialolithotomy during this procedure she was intubated nasally with a laser protected endotracheal tube. On (b)(6) 2015, surgeon documented that patient had developed a right nasal synechiae as a result of the nasal intubation with the laser protected tube. The synechiae had to be surgically divided in the clinic setting.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5056134
MDR Report Key5077543
Date Received2015-09-10
Date of Report2015-09-10
Date of Event2015-09-03
Date Added to Maude2015-09-15
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameLASER-SHIELD II ENDOTRACHEAL TUBE
Generic NameLASER-SHIELD II ENDOTRACHEAL TUBE
Product CodeBSK
Date Received2015-09-10
ID Number7060400
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC XOMED
Manufacturer AddressJACKSONVILLE FL US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2015-09-10

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