FDA Adverse Event Other Summary report: N

INFINITY ENTERAL FEEDING BAG

MDR report key: 2592134 · Received May 23, 2012

Report

Report Number
1722139-2012-00748
Event Type
Other
Date Received
May 23, 2012
Date of Event
April 24, 2012
Report Date
April 25, 2012
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
KNT
PMA / PMN Number
K012147
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO PRODUCTS WERE RETURNED FOR INVESTIGATION, UNABLE TO VERIFY THE COMPLAINT. DHR REVIEWED NO NON-CONFORMANCES RELATED TO PROVIDED LOT. NO INJURY ALLEGED BY PATIENT.

Description of Event or Problem · 1

CUSTOMER STATES: THE NEW STYLE OF BAGS STARTED HAVING PROBLEMS WITH NO FOOD AND NO FLOW IN CAUSING PATIENT HAD TO BE HOSPITALIZED FOR A SHORT PERIOD DUE TO NOT GETTING ENOUGH FOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INFINITY ENTERAL FEEDING BAG KNT MOOG MEDICAL DEVICES GROUP INF0500 CF1132807

Patients

Seq Age Sex Outcome Treatment
1