| Brand Name | BLUSELECT 9.0, SUCTIONAID, CUFFED, NON-FEN, 1/EA |
| Common Device Name | TUBE, TRACHEOSTOMY (W/WO CONNECTOR) |
| Manufacturer (Section D) |
| ICU MEDICAL HEALTHCARE MANUFACTURING S.A. DE C.V. |
| ave calidad no. 4, parque |
| tijuana |
| MX |
|
| Manufacturer Contact |
|
reed
covert
|
| 6000 nathan lane north |
| minneapolis, MN 55442
|
|
2247062300
|
|
| MDR Report Key | 25468704 |
| Report Number | 3012307300-2026-05933 |
| Device Sequence Number | 10466466 |
| Product Code |
BTO
|
| UDI-Device Identifier | 15019517078022 |
| UDI-Public | (01)15019517078022(17)300202(10)6084888 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | SW |
| PMA/510(K) Number | UNKNOWN |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,User Facility |
| Initial Reporter Occupation |
Nurse Practitioner
|
| Type of Report
| Initial |
| Report Date (Section B) |
06/11/2026 |
| 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 | 101/870/090 |
| Device Lot Number | 6084888 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 05/19/2026 |
| Initial Report FDA Received Date | 06/11/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 03/11/2025 |
| 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 Number | 1 |
| Patient Sex | Unknown |
|
|