FDA Adverse Event Malfunction Summary report: N

KANGAROO

MDR report key: 22006725 · Received May 12, 2025

Report

Report Number
1423537-2025-00198
Event Type
Malfunction
Date Received
May 12, 2025
Date of Event
April 8, 2025
Report Date
September 24, 2025
Manufacturer
CARDINAL HEALTH 200, LLC
Product Code
KNT
UDI-DI
10192253011562
PMA / PMN Number
K180622
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL 510K NUMBER: K932295. ADDITIONAL PRODUCT CODE: PIF. AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION THE RESULTS WILL BE FORWARDED.

Additional Manufacturer Narrative · 0

THE DEVICE HISTORY RECORD (DHR) FOR LOT NUMBER 2400121964 WAS REVIEWED AND NO ANOMALIES RELATED TO THE REPORTED ISSUE WERE OBSERVED. THERE WERE NO SAMPLES RETURNED FOR EVALUATION; THEREFORE, THE AFFECTED DEVICE COULD NOT BE EVALUATED TO CONFIRM THE REPORTED ISSUE. AS SUCH, A ROOT CAUSE COULD NOT BE DETERMINED AT THIS TIME. HOWEVER, A CORRECTIVE AND PREVENTATIVE ACTION HAS BEEN OPENED TO ADDRESS THE REPORTED ISSUE. WE WILL CONTINUE TO MONITOR RELATED REPORTS TO DETERMINE IF ADDITIONAL ACTIONS ARE NECESSARY.

Additional Manufacturer Narrative · 0

ONE DEVICE WAS RECEIVED FOR INVESTIGATION. THE DEVICE WAS INSPECTED, AND THE REPORTED CONDITION WAS OBSERVED. A SUPPLIER CORRECTIVE ACTION REQUEST HAS PREVIOUSLY BEEN SENT TO THE SUPPLIER TO FURTHER INVESTIGATE AND ADDRESS THE REPORTED CONDITION. WE WILL CONTINUE TO MONITOR RELATED REPORTS TO DETERMINE IF ADDITIONAL ACTIONS ARE NECESSARY.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THAT DURING THE PROCEDURE IT WAS NOTED THAT THE PROBE CUFF WAS PUNCTURED. THERE WAS NO HARM REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1825170 KANGAROO TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT CARDINAL HEALTH 200, LLC 8884720247 2400121964 10192253011562

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown