FDA Adverse Event
Malfunction
Summary report: N
NUTRISAFE 2 PUR FEEDING TUBE
MDR report key: 3873703
·
Received March 6, 2014
Report
- Report Number
- 2245270-2014-00013
- Event Type
- Malfunction
- Date Received
- March 6, 2014
- Date of Event
- January 30, 2014
- Report Date
- March 5, 2014
- Manufacturer
- VYGON SA
- Product Code
- FPD
- PMA / PMN Number
- K060944
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NURSE
Narratives
Additional Manufacturer Narrative · 1
TWO ADDITIONAL OCCURENCES OF THIS PRODUCT PROBLEM WERE OBSERVED BY THE CUSTOMER. ADDITIONAL INFORMATION ON THESE OCCURRENCES CAN BE FOUND IN THE FOLLOW MDR'S: 2245270-2014-00014 AND 00015. A MALFUNCTIONING DEVICE WAS RETURNED TO VYGON US AND WAS FORWARDED TO VYGON (B)(4) (THE MANUFACTURER) FOR DEVICE EVALUATION AND COMPLAINT INVESTIGATION. THE RESULTS OF THIS INVESTIGATION ARE STILL PENDING, AND WILL BE FORWARDED TO FDA UPON ITS COMPLETION VIA A FOLLOW-UP MDR.
Description of Event or Problem · 1
FEEDING TUBE MARKINGS ARE RUBBING OFF AROUND AREAS THAT IS TOUCHING BABY. FEEDING TUBE NEEDED TO BE REPLACED BECAUSE THERE WAS NO CLEAR INDICATION IF TUBE WAS MIGRATING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 134403 | NUTRISAFE 2 PUR FEEDING TUBE | ENTERAL FEEDING TUBE | FPD | VYGON SA | 1363.052 | 201212FE |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |