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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MALLINCKRODT MEDICAL SHILEY; TUBE TRACHEOSTOMY AND TUBE CUFF

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MALLINCKRODT MEDICAL SHILEY; TUBE TRACHEOSTOMY AND TUBE CUFF Back to Search Results
Model Number 7CN80R
Medical Device Problem Code Gas/Air Leak (2946)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/27/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the two cuff of the tracheostomy tubes leaked air when checked before insertion.When inflated the cuff to a pressure of 25 cmh2o and immersed in normal saline, bubbles were observed, indicating air leakage.There was no patient involvement.
 
Additional Manufacturer Narrative
D10 concomitant product: 7cn80r, 7cn80r 8.0mm adt flex trach w tg cuff x1, (lot #202501391x) medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Additional Manufacturer Narrative
Additional information: d9, g3, h3, h6 correction: b5 h3 evaluation summary: medtronic conducted an investigation based upon all information received.The device was available for evaluation.Visual inspection noted that the cuff showed three slits on the main body.Functionally, an attempt made to inflate the returned unit failed.It was reported that the two cuffs of the tracheostomy tubes leaked air when checked before insertion.When inflated the cuff to a pressure of 25 cm h2o and immersed in normal saline, bubbles were observed, indicating air leakage.The reported issue was confirmed.The most likely cause was the cuff body came in contact with a sharp utensil or object.The manufacturing records for each device are thoroughly reviewed prior to release to ensure that it meets all medtronic quality specifications.The instructions included with this device provide the following guidance: to ease insertion and to guard against cuff perforation from sharp edges of cartilage, taper back the cuff by deflating the cuff and gently moving it away from the distal tip of the cannula toward the neck plate as the residual air is removed by deflation.When tapering the cuff, do not use sharp instruments that would damage the cuff, such as forceps or hemostats.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
It was reported that the two cuffs of the tracheostomy tubes leaked air when checked before insertion.When inflated the cuff to a pressure of 25 cm h2o and immersed in normal saline, bubbles were observed, indicating air leakage.There was no patient involvement.
 
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Brand Name
SHILEY
Common Device Name
TUBE TRACHEOSTOMY AND TUBE CUFF
Manufacturer (Section D)
MALLINCKRODT MEDICAL
cornamaddy
athlone 3810
EI  3810
Manufacturer (Section G)
MALLINCKRODT MEDICAL
cornamaddy
athlone 3810
EI   3810
Manufacturer Contact
mike bocchino
8200 coral sea st ne
mounds view, MN 55112-4391
8006464633
MDR Report Key23444717
Report Number8020889-2025-00424
Device Sequence Number15424908
Product Code JOH
UDI-Device Identifier10884521205444
UDI-Public(01)10884521205444(17)300201(10)202502344X(20)01
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K150844
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/13/2026
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
Operator of Device Health Professional
Device Model Number7CN80R
Device Catalogue Number7CN80R
Device Lot Number202502344X
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/27/2025
Supplement Date Received by Manufacturer02/11/2026
Initial Report FDA Received Date11/03/2025
Supplement Report FDA Received Date02/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/24/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
SEE H11
Patient SexUnknown
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