BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DAVOL, INC

    MDR report key: 16288 · Received February 4, 1994

    Report

    Report Number
    16288
    Event Type
    Injury
    Date Received
    February 4, 1994
    Date of Event
    November 18, 1993
    Report Date
    November 19, 1993
    Manufacturer
    DAVOL, INC.
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PATIENT ADMITTED 9/16/93 WITH NG TO LEFT NOSTRIL. NG NOT CHANGED DURING HOSPITALIATION. PATIENT COMPLAINED OF INCREASED ABDOMINAL DISTRESS & KUB (ABD. X-RAY) ORDERED 11/10/93. KINKED TUBE NOTED.REMOVAL REQUIRED CUTIING NG TUBE & REMOVING KNOTTED PORTION VIA MOUTH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DAVOL, INC LEVIN 4416 DAVOL, INC. 4416 UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention PURITN BENNETT 7200 VENTILATOR