AIRFLOW ADULT RESUSCITATOR AF1140MBP-T

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-11-02 for AIRFLOW ADULT RESUSCITATOR AF1140MBP-T manufactured by Ventlab, Llc., A Subsidiary Of Sunmed.

Event Text Entries

[59132409] Air flow ambu bag tubing has kinks.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5065792
MDR Report Key6078360
Date Received2016-11-02
Date of Report2016-10-25
Date Added to Maude2016-11-04
Event Key0
Report Source CodeVoluntary 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 Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameAIRFLOW ADULT RESUSCITATOR
Generic NameAMBU BAG
Product CodeNHK
Date Received2016-11-02
Model NumberAF1140MBP-T
Lot Number306289
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerVENTLAB, LLC., A SUBSIDIARY OF SUNMED
Manufacturer Address2710 NORTHRIDGE DR NW SUITE A GRAND RAPIDS MI 49544 US 49544


Patients

Patient NumberTreatmentOutcomeDate
10 2016-11-02

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