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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CARDINAL HEALTH RIGID YANKAUER SET 10'; APPARATUS, SUCTION, OPERATING-ROOM, WALL VACUUM POWERED

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CARDINAL HEALTH RIGID YANKAUER SET 10'; APPARATUS, SUCTION, OPERATING-ROOM, WALL VACUUM POWERED Back to Search Results
Model Number 8888505040
Device Problem Sharp Edges (4013)
Patient Problem Laceration(s) (1946)
Event Type  malfunction  
Manufacturer Narrative
The complainant indicated that the device will not be returned for evaluation; therefore, a failure analysis is not available, and we are not able to determine the relationship between this device and the cause for this event.If additional information or the sample is received, the investigation will be reopened and responded to accordingly.
 
Event Description
The customer reported that they had a patient end up with wounds behind their mouth after using this suction tip.The suction tip has holes on the side near the tip that are cut so that the edges of the holes are sharp.
 
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Brand Name
RIGID YANKAUER SET 10'
Type of Device
APPARATUS, SUCTION, OPERATING-ROOM, WALL VACUUM POWERED
Manufacturer (Section D)
CARDINAL HEALTH
calle 9 sur no. 125 cuidad ind
tijuana 22500
MX  22500
MDR Report Key12738904
MDR Text Key279612523
Report Number9612030-2021-03073
Device Sequence Number1
Product Code GCX
UDI-Device Identifier10884527019977
UDI-Public10884527019977
Combination Product (y/n)N
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial
Report Date 11/02/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/02/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator No Information
Device Model Number8888505040
Device Catalogue Number8888505040
Was Device Available for Evaluation? No
Date Manufacturer Received10/19/2021
Is the Device Single Use? Yes
Type of Device Usage N
Patient Sequence Number1
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