FDA Adverse Event Malfunction Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING SET

MDR report key: 2002620 · Received February 8, 2011

Report

Report Number
1722139-2011-00012
Event Type
Malfunction
Date Received
February 8, 2011
Date of Event
January 18, 2011
Report Date
February 8, 2011
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
KNT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCT WAS RETURNED FOR EVALUATION HOWEVER THE ISSUE WAS CLEARLY EXPLANTED BY THE CUSTOMER. THE REPORTED DEFECT WAS NOTICED DURING PRIMING OF THE SET. THIS COMPLAINT COULD NOT BE VERIFIED.

Description of Event or Problem · 1

CUSTOMER REPORTED THAT THE PRODUCT TUBING WAS ASSEMBLED BACKWARDS CAUSING FLUID TO RUN IN THE OPPOSITE DIRECTION. THE REVERSED TUBING WAS NOTICED WHILE PRIMING THE SET AT THE SET WAS NOT HOOKED UP TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENTERALITE INFINITY ENTERAL FEEDING SET KNT MOOG MEDICAL DEVICES GROUP INF0500 CF1024304

Patients

Seq Age Sex Outcome Treatment
1