BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CORFLO - ULTRA LITE SBF NG

    MDR report key: 290700 · Received August 15, 2000

    Report

    Report Number
    1419949-2000-00011
    Event Type
    Injury
    Date Received
    August 15, 2000
    Date of Event
    July 25, 2000
    Report Date
    August 14, 2000
    Manufacturer
    CORPAK MEDSYSTEMS
    Product Code
    FPD
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    SBF TUBE PLACED BY MD WITHOUT INCIDENT. PER FOLLOW-UP X-RAY, TUBE FOUND TO BE LOOPED BACK UP FROM STOMACH, INTO ESOPHAGUS, THROUGH ESOPHAGEAL WALL AND THROUGH THE PLEURAL SPACE. PT STABLE, BUT HAD PNEUMOTHORAX ON X-RAY THAT DID REQUIRE PLACEMENT OF CHEST TUBE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORFLO - ULTRA LITE SBF NG ENTERAL FEEDING TUBE FPD CORPAK MEDSYSTEMS NA 2722

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Death| R