STETHOSCOPE ESOPHAGEAL WITH ELECTRICAL CONDUCTORS ES400-18

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2006-06-05 for STETHOSCOPE ESOPHAGEAL WITH ELECTRICAL CONDUCTORS ES400-18 manufactured by Smiths Medical Asd, Inc..

Event Text Entries

[17441270] User alleges that attempting to pull esophageal probe back out of the pt the white cord broke. The probe was removed by the doctor "snagging" esophageal stethoscope.
Patient Sequence No: 1, Text Type: D, B5


[17548826] Evaluation-other: the probe was discarded at the facility. Smiths medical asd, inc is unable to perform a thorough investigation without the return of the actual sample involved. If info is received other than what is reported; then a follow up report will be filed. A review of the complaints database shows no reports on this catalog number or lot number. In addition, a review of mfg records for this catalog number indicated no problems that would provide an explanation for this event.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1221261-2006-00017
MDR Report Key734485
Report Source06
Date Received2006-06-05
Date of Report2006-06-05
Date of Event2006-04-03
Device Manufacturer Date2006-03-01
Date Added to Maude2006-07-17
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactTIM MATSON
Manufacturer Street10 BOWMAN DR
Manufacturer CityKEENE NH 03431
Manufacturer CountryUS
Manufacturer Postal03431
Manufacturer Phone6033523812
Manufacturer G1SMITHS HEALTHCARE MFG S.A. DE C.V.
Manufacturer StreetAVE. CALIDAD NO. 4 PRQUE IND. INTERNACIONAL, OTAY
Manufacturer CityUNIVERSIDAD TIJUANA, BC 22427
Manufacturer CountryMX
Manufacturer Postal Code22427
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSTETHOSCOPE ESOPHAGEAL WITH ELECTRICAL CONDUCTORS
Generic NameACOUSTASCOPE ESOPHAGEAL STETHOSCOPE W/TEMP SENSOR
Product CodeBZT
Date Received2006-06-05
Model NumberES400-18
Catalog NumberES400-18
Lot Number5199
ID NumberNA
Device Expiration Date2009-02-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key722356
ManufacturerSMITHS MEDICAL ASD, INC.
Manufacturer Address160 WEYMOUTH ST. ROCKLAND MA 02370 US
Baseline Brand NameES400-18
Baseline Generic NameTEMPERATURE SENSOR
Baseline Model NoES400-18
Baseline Catalog NoES400-18
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2006-06-05

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