BEUDAMED
    FDA Adverse Event Death Summary report: N

    PERCUTANEOUS ENDOSCOPIC GASTOSTOMY JEJUNAL FEEDING TUBE

    MDR report key: 107326 · Received July 22, 1997

    Report

    Report Number
    1037905-1997-00040
    Event Type
    Death
    Date Received
    July 22, 1997
    Date of Event
    June 19, 1997
    Report Date
    June 24, 1997
    Manufacturer
    WILSON-COOK MEDICAL, INC.
    Product Code
    KNT
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    HI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A PERCUTANEOUS ENDOSCOPIC GASTROSTOMY JEJUNAL FEEDING TUBE WAS PLACED. THE GJ TUBE WAS PLACED THROUGH ANOTHER MFR'S PEG FEEDING TUBE. THE PT WAS DIAGNOSED WITH RENAL DISEASE AND SYSTEMIC LUPUS ERYTHEMATOSUS. IT WAS NOTED LATER AFTER THE PROCEDURE, THE DUODENUM HAD BEEN PERFORATED. THE PT LATER EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERCUTANEOUS ENDOSCOPIC GASTOSTOMY JEJUNAL FEEDING TUBE JEJUNAL FEEDING TUBE KNT WILSON-COOK MEDICAL, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 90 YR Death