BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    *

    MDR report key: 1823080 · Received August 6, 2010

    Report

    Report Number
    1823080
    Event Type
    Malfunction
    Date Received
    August 6, 2010
    Date of Event
    July 12, 2010
    Report Date
    August 6, 2010
    Manufacturer
    KIMBERLY CLARK
    Product Code
    KNT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US

    Narratives

    Description of Event or Problem · 1

    THERE WAS A POSSIBLE ASPIRATION EPISODE DUE TO THE TUBE FEEDING BEING CONNECTED TO THE WRONG PORT. A BRONCHOSCOPY WAS NEGATIVE FOR ASPIRATION, IT SHOWED A MUCUS PLUG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * TUBE, FEEDING, TRANSGASTRIC, JEJUNAL KNT KIMBERLY CLARK * *

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR