BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GASTROSTOMY TUBE

    MDR report key: 33261 · Received May 30, 1996

    Report

    Report Number
    MW1009185
    Event Type
    Malfunction
    Date Received
    May 30, 1996
    Date of Event
    May 24, 1996
    Report Date
    May 27, 1996
    Manufacturer
    MEDICAL INNOVATIONS CORP.
    Product Code
    KNT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BALLOON BROKEN, NEW GASTROSTOMY TUBE HAD TO BE INSERTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GASTROSTOMY TUBE BALLOON KNT MEDICAL INNOVATIONS CORP. 5020301

    Patients

    Seq Age Sex Outcome Treatment
    1 93 YR