BEUDAMED
    FDA Adverse Event Other Summary report: N

    MEDI-TECH

    MDR report key: 379211 · Received February 28, 2002

    Report

    Report Number
    379211
    Event Type
    Other
    Date Received
    February 28, 2002
    Date of Event
    January 3, 2002
    Report Date
    January 9, 2002
    Manufacturer
    BOSTON SCIENTIFIC (MEDI-TECH)
    Product Code
    GBX
    Report Source
    User Facility report
    Reporter Location
    WI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DURING THE FEEDING JEJUNOSTOMY CHANGE, THE DISTAL 3-5CM OF THE MEDI-TECH 10FR APD CATHETER BROKE OFF. IT COULD NOT BE EXTRACTED. IT REMAINED IN THE JEJUNEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDI-TECH ALL PURPOSE DRAINAGE CATHETER GBX BOSTON SCIENTIFIC (MEDI-TECH) * 4398505

    Patients

    Seq Age Sex Outcome Treatment
    1 1 YR Other