FDA Adverse Event Injury Summary report: N

NEOMED POLYURETHANE FEEDING TUBES (NON ENFIT)

MDR report key: 18135434 · Received November 14, 2023

Report

Report Number
3011270181-2023-00132
Event Type
Injury
Date Received
November 14, 2023
Date of Event
September 21, 2023
Report Date
February 14, 2024
Manufacturer
AVANOS MEDICAL INC.
Product Code
FPD
UDI-DI
00350770002187
PMA / PMN Number
K082238
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
RISK MANAGER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE SAMPLE IS REPORTED TO BE AVAILABLE BUT HAS NOT YET BEEN RECEIVED BY THE MANUFACTURER. A REVIEW OF THE DEVICE HISTORY RECORD IS NOT POSSIBLE AS NO LOT NUMBER WAS PROVIDED. ALL INFORMATION REASONABLY KNOWN AS OF 13 NOV 2023 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AVANOS MEDICAL INC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT/REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AVANOS MEDICAL INC. AVANOS MEDICAL INC. HAS NO INDEPENDENT KNOWLEDGE OF THE REPORTED EVENT BUT IS RELAYING THE INFORMATION PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AVANOS MEDICAL COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AVANOS MEDICAL INC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY. H3 OTHER TEXT: DEVICE NOT RETURNED.

Additional Manufacturer Narrative · 0

ALL INFORMATION REASONABLY KNOWN AS OF 13 FEB 2024 HAS BEEN INCLUDED IN THIS HEALTH AUTHORITY REPORT. SHOULD ADDITIONAL INFORMATION BE OBTAINED, A FOLLOW-UP HEALTH AUTHORITY REPORT WILL BE PROVIDED. THE INFORMATION PROVIDED BY AVANOS MEDICAL INC. REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT/REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO AVANOS MEDICAL INC. AVANOS MEDICAL INC. HAS NO INDEPENDENT KNOWLEDGE OF THE REPORTED EVENT BUT IS RELAYING THE INFORMATION PROVIDED BY THE USER FACILITY WHERE THE INCIDENT OCCURRED. THIS PRODUCT INCIDENT IS DOCUMENTED IN THE AVANOS MEDICAL COMPLAINT DATABASE AND IDENTIFIED AS COMPLAINT (B)(4). THIS INFORMATION IS SUBMITTED PURSUANT TO 21CFR803, IN COMPLIANCE WITH THE MEDICAL DEVICE REPORTING REQUIREMENT AND SHOULD NOT BE CONSIDERED TO BE AN ADMISSION THAT AN AVANOS MEDICAL INC. PRODUCT IS DEFECTIVE OR CAUSED SERIOUS INJURY.

Description of Event or Problem · 0

AVANOS MEDICAL INC. RECEIVED A SINGLE REPORT THAT REFERENCED THREE DIFFERENT INCIDENCES, WHICH WERE ASSOCIATED WITH SEPARATE UNITS. THIS IS THE THIRD OF THREE REPORTS. REFER TO 3011270181-2023-00130 FOR THE FIRST REPORT. REFER TO 3011270181-2023-00131 FOR THE SECOND REPORT. IT WAS REPORTED, NASOGASTRIC TUBE (NGT) MAL POSITIONS. THREE INSERTION ATTEMPTS WERE MADE, AND ALL WERE MAL-POSITIONED. PATIENT ORAL FEEDING WAS DELAYED BY ABOUT A WEEK. NO LONG-TERM ADVERSE PATIENT IMPACT EXPECTED. EXACT LOCATION OF MALPOSITION NOT REPORTED.

Description of Event or Problem · 0

PER ADDITIONAL INFORMATION RECEIVED ON 17JAN2024, ¿THE TUBE MALPOSITION WAS CONFIRMED THROUGH X-RAY AND THERE IS NO MORE INFORMATION AVAILABLE.¿

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2040969 NEOMED POLYURETHANE FEEDING TUBES (NON ENFIT) DH NASOGASTRIC (NG) FEEDING TUBES (NEOMED AND NEOCONNECT) FPD AVANOS MEDICAL INC. FTS5.0P-EO UNKNOWN 00350770002187

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other