| Brand Name | SHERIDAN ET TUBE,CF,6.0 |
| Common Device Name | TUBE, TRACHEAL (W/WO CONNECTOR |
| Manufacturer (Section D) |
| TELEFLEX MEDICAL |
| morrisville NC |
|
| Manufacturer (Section G) |
| TELEFLEX MEDICAL |
| rancho el descanso |
|
| tecate 21478 |
|
MX
21478
|
|
| Manufacturer Contact |
|
laura guadalupe
gonzalez
|
| 3015 carrington mill blvd |
| morrisville, NC 27560
|
|
| MDR Report Key | 25156508 |
| Report Number | 3003898360-2026-00231 |
| Device Sequence Number | 9581940 |
| Product Code |
BTR
|
| UDI-Device Identifier | 04026704396788 |
| UDI-Public | (01)04026704396788(11)241006(17)291005(10)73K2400080(21) |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K822082 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility,Distributor |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial |
| Report Date (Section B) |
04/16/2026 |
| 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 Catalogue Number | 5-10112 |
| Device Lot Number | 73K2400080 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 04/16/2026 |
| Initial Report FDA Received Date | 05/12/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 10/06/2024 |
| 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 Number | 1 |
Concomitant Medical Products and Therapy/Usage Dates | NONE REPORTED. |
| Patient Sex | Unknown |
|
|