inforMED
MalfunctionDYN

CROSS PROTECTION

Received Nov 2, 2017

Report MW5073095 · MDR key 6996097

Device

Generic name

Saliva Ejector

Model number

5-501 CB

Product problems

  • Detachment Of Device Component

Patient

4 YR

  • No Known Impact Or Consequence To Patient
  • No Known Impact Or Consequence To Patient

Narrative

Description of Event or Problem

THE TIP OF EJECTOR FELL OF CLEAR TUBE POST ENDOTRACHEAL INTUBATION INTO OROPHARYNX. THE DEVICE WAS INTACT PRIOR USE AND WAS PERFORMED PROPERLY DURING FIRST THREE ORAL SUCTIONS.