Model Number 101/870/075 |
Device Problem
Disconnection (1171)
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Patient Problem
Insufficient Information (4580)
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Event Date 08/01/2023 |
Event Type
malfunction
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Manufacturer Narrative
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Other text: b3: month and year of event have been provided; day is unknown.D4: lot number, expiration date and h4: device manufacture date is unknown, no information has been provided to date.Investigation including root cause analysis is in progress.A supplemental mdr will be filed as necessary in accordance with 21 cfr 803.56 when additional reportable information becomes available.
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Event Description
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It was reported that the pilot balloon was replaced in the morning, and in the afternoon of the same day.It was discovered that the pilot balloon had fallen off, and use was discontinued.Adverse patient effects are unknown.
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Manufacturer Narrative
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Device evaluation: one device was returned for investigation.Under visual inspection the inflation line was found detached from the pilot balloon as reported by customer.The complaint was confirmed.This was listed as a supplied item fault.This issue will continue to be monitored and further actions taken accordingly.No lot number was provided therefore no device history report (dhr) review could be completed.
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Search Alerts/Recalls
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