FDA Adverse Event Malfunction Summary report: N

KANGAROO

MDR report key: 22151453 · Received June 5, 2025

Report

Report Number
1423537-2025-00225
Event Type
Malfunction
Date Received
June 5, 2025
Date of Event
December 17, 2024
Report Date
July 1, 2025
Manufacturer
CARDINAL HEALTH, INC.
Product Code
KNT
UDI-DI
10884521661721
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 PRODUCT CODE: PIF. ADDITIONAL 510 K NUMBER: K932295. AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

Additional Manufacturer Narrative · 0

THE DEVICE HISTORY RECORD (DHR) FOR LOT NUMBER 2233328464 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 FAILURE MODE. AS SUCH, A ROOT CAUSE COULD NOT BE DETERMINED. HOWEVER, THE REPORTED AFFECTED COMPONENT IS PRODUCED BY AN EXTERNAL SUPPLIER; OUR ASSEMBLY PROCESS CONSISTS ONLY OF A PICK AND PLACE OPERATION FOR THIS MATERIAL. A SUPPLIER CORRECTIVE ACTION REQUEST HAS BEEN SENT TO THE SUPPLIER TO FURTHER INVESTIGATE AND ADDRESS THE REPORTED CONDITION. ALL INFORMATION RECEIVED WILL BE USED FOR TRACKING AND TRENDING PURPOSES.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THAT A BALLOON TEST WAS PERFORMED AND THE BALLOON SHOWED A SMALL AMOUNT OF RETURN. THERE WAS NO PATIENT HARM REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
45280 KANGAROO TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT CARDINAL HEALTH, INC. 8884720221 2233328464 10884521661721

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown