FDA Adverse Event Malfunction Summary report: N

KANGAROO

MDR report key: 22652138 · Received July 29, 2025

Report

Report Number
1423537-2025-00295
Event Type
Malfunction
Date Received
July 29, 2025
Date of Event
June 14, 2025
Report Date
August 27, 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

AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED. ADDITIONAL PRODUCT CODE (D2A): PIF. ADDITIONAL 510(K)NUMBER (G4): K932295.

Additional Manufacturer Narrative · 0

THE DEVICE HISTORY RECORD WAS REVIEWED AND INDICATED THAT THE PRODUCT WAS RELEASED ACCOMPLISHING ALL QUALITY STANDARDS. PRIOR TO A LOT¿S RELEASE, THE LOT MUST BE DEEMED ACCEPTABLE BY PASSING INSPECTIONS THAT ARE BASED ON A VALID SAMPLING PLAN. DURING PRODUCTION, INSPECTORS ROUTINELY EXAMINE A STATISTICAL SAMPLE BOTH PHYSICALLY AND VISUALLY. A DEVICE WAS NOT 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 AT THIS TIME. HOWEVER, A SUPPLIER CORRECTIVE ACTION REQUEST HAS 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 THE G-TUBE WAS REPLACED ON (B)(6) 2025 AND ON (B)(6) "2026" THE G-TUBE BALLOON RUPTURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1161098 KANGAROO TUBES, GASTROINTESTINAL (AND ACCESSORIES) KNT CARDINAL HEALTH 200, LLC 8884720247 2400216664 10192253011562

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown