BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MOSS

    MDR report key: 1577773 · Received January 8, 2010

    Report

    Report Number
    MW5014306
    Event Type
    Injury
    Date Received
    January 8, 2010
    Date of Event
    December 10, 2009
    Report Date
    January 8, 2010
    Manufacturer
    MOSS TUBES, INC.
    Product Code
    KNT
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBE FEEDING CONNECTED TO G TUBE PORT INSTEAD OF J TUBE PORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MOSS GASTROSTOMY TUBE, 18F KNT MOSS TUBES, INC. 18F-MOSS

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Hospitalization