BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SAGE ORAL CARE SUCTION SWAB

    MDR report key: 3792992 · Received April 30, 2014

    Report

    Report Number
    MW5035905
    Event Type
    Injury
    Date Received
    April 30, 2014
    Date of Event
    April 16, 2014
    Report Date
    April 21, 2014
    Manufacturer
    SAGE PRODUCTS, INC.
    Product Code
    KXF
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE GREEN PORTION OF THE SUCTION SWAB HAD TO BE EXTRACTED DURING AN EGD PROCEDURE AS IT WAS OBSTRUCTING THE NASOGASTRIC TUBE PLACEMENT. THE FOREIGN BODY WAS BROKEN OFF FROM THE STICK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    260115 SAGE ORAL CARE SUCTION SWAB SUCTION SWAB KXF SAGE PRODUCTS, INC. 42625

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Required Intervention