BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NEOMED 5.OFR 40 CM PVC

    MDR report key: 10967451 · Received December 7, 2020

    Report

    Report Number
    MW5098252
    Event Type
    Malfunction
    Date Received
    December 7, 2020
    Date of Event
    November 30, 2020
    Report Date
    December 4, 2020
    Manufacturer
    AVANOS MEDICAL, INC.
    Product Code
    KNT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    FEEDING TUBE PORT THAT CONNECTS TO TUBING CAME DISLODGED FROM TUBING. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1427619 NEOMED 5.OFR 40 CM PVC TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT AVANOS MEDICAL, INC. FTS5.0V-EO 20180505(?PKG NOT AVAIL)

    Patients

    Seq Age Sex Outcome Treatment
    1 17 DA