FOREGGER LARYNGOSCOPE MILLER 0 UNK

MAUDE Adverse Event Report

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 *.

Event Text Entries

[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 When laryngoscope was withdrawn following intubation, the light bulb was no longer attached.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


MAUDE Entry Details

Report Number530318
MDR Report Key530318
Date Received2004-06-16
Date of Report2004-06-01
Date of Event2004-05-17
Date Facility Aware2004-05-24
Report Date2004-06-01
Date Reported to FDA2004-06-01
Date Added to Maude2004-06-21
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameFOREGGER LARYNGOSCOPE
Generic NameLARYNGOSCOPE
Product CodeEQN
Date Received2004-06-16
Model NumberMILLER 0
Catalog NumberUNK
Lot NumberUNK
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age4 YR
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key519546
Manufacturer*
Manufacturer Address* * *


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2004-06-16

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