FDA Adverse Event Injury Summary report: N

MIC-KEY GASTRIC-JEJUNAL FEEDING TUBE KIT

MDR report key: 18066024 · Received November 2, 2023

Report

Report Number
MW5147732
Event Type
Injury
Date Received
November 2, 2023
Date of Event
September 21, 2023
Report Date
October 18, 2023
Manufacturer
AVANOS MEDICAL, INC. (FORMERLY HALYARD HEALTH INC.)
Product Code
KNT
Adverse Event
Yes
Product Problem
Yes
Report Source
Voluntary report
Reporter Occupation
UNKNOWN
Health Professional
*

Narratives

Description of Event or Problem · 0

A GJ FEEDING TUBE BY AVANOS HAD A FAULTY BALLOON THAT REQUIRED REPLACEMENT. THIS HAS HAPPENED THREE TIMES NOW. THE GJ TUBE HAD BEEN IN PLACE 1 WEEK, 1 MONTH, AND 2 WEEKS RESPECTIVELY. THE REF NUMBER OF THE PART IS: 8270-14-1.0-22. WE HAVE KEPT THE BOXES OF THE LAST TWO AND BOTH WERE MANUFACTURED ON 2023-07-12 AND HAD A LOT NUMBER OF 30268249. ALL CARE INSTRUCTIONS WERE FOLLOWED, AND EACH TIME THE BALLOON SPONTANEOUSLY FAILED. THIS HAS LED TO FLUID LOSS, SKIN IRRITATION, AN INABILITY TO CONTINUE DAILY ACTIVITIES, AND A RETURN TRIP TO INTERVENTIONAL RADIOLOGY TO REPLACE THE TUBE. THIS PIECE OF EQUIPMENT IS SUPPOSED TO LAST A MINIMUM OF 6 MONTHS. PLEASE ISSUE A RECALL AS THIS EFFECTS THE ABILITY OF PEOPLE USING THE PRODUCT TO RECEIVE NUTRITION, HYDRATION, AND MEDICATION. REFERENCE REPORTS MW5147730, MW5147731.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
341211 MIC-KEY GASTRIC-JEJUNAL FEEDING TUBE KIT TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT AVANOS MEDICAL, INC. (FORMERLY HALYARD HEALTH INC.)

Patients

Seq Age Sex Outcome Treatment
1 4 YR Female