BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CORFLO ULTRA ENTERAL FEEDING TUBE

    MDR report key: 3226579 · Received July 9, 2013

    Report

    Report Number
    MW5030854
    Event Type
    Injury
    Date Received
    July 9, 2013
    Date of Event
    July 7, 2013
    Report Date
    July 9, 2013
    Manufacturer
    CORPAK MEDSYSTEM
    Product Code
    FPD
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BABY PULLED 8FR ORAL-DUODENAL TUBE CORPAK WEIGHTED ENTERAL FEEDING TUBE OUT. END OF TUBE NOTED TO BE MISSING WEIGHTED END. NNP AND NEONATOLOGIST NOTIFIED. XRAY SHOWED THE REMAINING TIP OF THE TUBE. CHOP SURGEON CONSULTED AND IN TO EVALUATE PT FOR SURGERY. BABY TRANSFERRED TO CHOP FOR PROBABLE SURGICAL INTERVENTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    312817 CORFLO ULTRA ENTERAL FEEDING TUBE ENTERAL FEEDING TUBE FPD CORPAK MEDSYSTEM 35820

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Required Intervention