MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2004-06-16 for FOREGGER LARYNGOSCOPE MILLER 0 UNK manufactured by *.
[337918]
Physician intubating pt. When laryngoscope was withdrawn following intubation, the light bulb was no longer attached. X-ray revealed bulb in pt's stomach. Pt passed the light bulb through gi tract.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 530318 |
| MDR Report Key | 530318 |
| Date Received | 2004-06-16 |
| Date of Report | 2004-06-01 |
| Date of Event | 2004-05-17 |
| Date Facility Aware | 2004-05-24 |
| Report Date | 2004-06-01 |
| Date Reported to FDA | 2004-06-01 |
| Date Added to Maude | 2004-06-21 |
| 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 | 3 |
| Reporter Occupation | RISK MANAGER |
| 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 | FOREGGER LARYNGOSCOPE |
| Generic Name | LARYNGOSCOPE |
| Product Code | EQN |
| Date Received | 2004-06-16 |
| Model Number | MILLER 0 |
| Catalog Number | UNK |
| Lot Number | UNK |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | 4 YR |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 519546 |
| Manufacturer | * |
| Manufacturer Address | * * * |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2004-06-16 |