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