InjuryBTK
MARPAC ADJUSTABLE ET TUBE HOLDER
Received Sep 8, 2020 · Event occurred Jul 8, 2020
Report MW5096466 · MDR key 10507178
Device
Generic name
Strap, Head Gas Mask
Manufacturer
Marpac, Inc.Product problems
- Material Rupture
- Device Dislodged or Dislocated
Patient
79 YR
- Insufficient Information
- Insufficient Information
Narrative
Description of Event or Problem
RN AND EXTENDER WERE IN THE ROOM CLEANING THE PT. AS THE PT WAS TURNED WITH ENOUGH SLACK TO THE VENT TUBING, THE HOLLISTER BROKE AND THE ETT BECAME DISLODGED. STAFF NOTICED THE BALLOON WAS DEFLATED AND CALLED A CODE BLUE OVERHEAD TO INITIATE URGENT RE-INTUBATION. PT WAS BAGGED WHILE BEING PREPPED FOR RE-INTUBATION. VITAL SIGNS REMAINED STABLE THROUGHOUT. FDA SAFETY REPORT ID# (B)(4).