FDA Adverse Event
Summary report: N
AMS-372 60" ENTERAL FEEDING SET
MDR report key: 1935571
·
Received November 23, 2010
Report
- Report Number
- 1935571
- Date Received
- November 23, 2010
- Date of Event
- October 29, 2010
- Report Date
- November 23, 2010
- Manufacturer
- CHURCHILL MEDICAL SYSTEMS, INC.
- Product Code
- KNT
- Report Source
- User Facility report
- Reporter Location
- MD, US
Narratives
Description of Event or Problem · 1
PATIENT'S FEEDING TUBE WAS CONNECTED TO THE PERIPHERAL IV INSTEAD OF THE GAVAGE TUBE. THIS WAS A MEDICAL MISCONNECTION: THE ENTERAL FEEING TUBE WAS COMPATIBLE WITH LUER-LOCK/PIV CONNECTOR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | AMS-372 60" ENTERAL FEEDING SET | ENTERAL FEEDING SET | KNT | CHURCHILL MEDICAL SYSTEMS, INC. | AMS-372 | 1006013 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 3 DA |