BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    KANGAROO

    MDR report key: 12413355 · Received September 2, 2021

    Report

    Report Number
    12413355
    Event Type
    Malfunction
    Date Received
    September 2, 2021
    Date of Event
    May 20, 2021
    Report Date
    August 23, 2021
    Manufacturer
    COVIDIEN LP
    Product Code
    KNT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PATIENT HAD A COVIDIEN LP KANGAROO¿ ADULT NASOGASTRIC FEEDING TUBE PLACED, AND DURING RN'S ASSESSMENT NEXT MORNING, THE PURPLE DUAL PORT WAS CRACKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1313415 KANGAROO TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT COVIDIEN LP

    Patients

    Seq Age Sex Outcome Treatment
    1 14235 DA