Type of Device | CONNECTOR, AIRWAY (EXTENSION) |
Manufacturer (Section D) |
SMITHS MEDICAL INTERNATIONAL, LTD. |
bramingham business park, enterprise way |
luton, bedforshire LU3 4 BU |
UK LU3 4BU |
|
MDR Report Key | 10806434 |
MDR Text Key | 215260267 |
Report Number | 3012307300-2020-11236 |
Device Sequence Number | 1 |
Product Code |
BZA
|
Combination Product (y/n) | N |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,user facility |
Type of Report
| Initial |
Report Date |
11/08/2020 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
No Information
|
Device Catalogue Number | DK-OK50JP |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 10/14/2020 |
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
10/09/2020
|
Initial Date FDA Received | 11/08/2020 |
Was Device Evaluated by Manufacturer? |
No
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|