BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MIC

    MDR report key: 3934481 · Received July 10, 2014

    Report

    Report Number
    MW5037244
    Event Type
    Injury
    Date Received
    July 10, 2014
    Date of Event
    June 15, 2014
    Report Date
    July 9, 2014
    Manufacturer
    KIMBERLY-CLARK CORP
    Product Code
    KNT
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    GASTRIC FEEDING TUBE CLOSURE CAP BROKE OFF TUBE. ANOTHER CAP WAS PLACED OVER GASTRIC TUBE AND TAPED IN PLACE TO CLOSE DEVICE - REPLACEMENT CAP CAME OFF AND GASTRIC CONTENTS LEAKED ON TO SKIN. PARTIAL THICKNESS BURN-LIKE INJURY TO BILATERAL ARMS AND ABDOMEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    402508 MIC GASTRIC FEEDING TUBE KNT KIMBERLY-CLARK CORP

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Other