BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KENDALL KANGAROO PUMP TUBING

    MDR report key: 1183062 · Received July 28, 2008

    Report

    Report Number
    1183062
    Event Type
    Malfunction
    Date Received
    July 28, 2008
    Date of Event
    July 6, 2008
    Report Date
    July 28, 2008
    Manufacturer
    COVIDIEN KENDALL
    Product Code
    LZH
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US

    Narratives

    Description of Event or Problem · 1

    WHILE ADMINISTERING MED THROUGH SIDE PORT OF NG TUBE AND WHILE FEEDING MACHINE ON "HOLD", TUBING BECAME DISCONNECTED AT BLACK PORT BELOW THE FILL CHAMBER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KENDALL KANGAROO PUMP TUBING TUBING, ENTERAL FEEDING LZH COVIDIEN KENDALL * *

    Patients

    Seq Age Sex Outcome Treatment
    1 5 MO