FDA Adverse Event
Summary report: N
DALE ACE CONNECTOR
MDR report key: 4331461
·
Received December 9, 2014
Report
- Report Number
- 4331461
- Date Received
- December 9, 2014
- Date of Event
- November 16, 2014
- Report Date
- December 9, 2014
- Manufacturer
- DALE MEDICAL PRODUCTS, INC.
- Product Code
- KNT
- Report Source
- User Facility report
- Reporter Location
- MI, US
Narratives
Description of Event or Problem · 1
THE PATIENT WAS FOUND WITH A POOL OF TUBE FEEDS ON HIS LAP. THE DALE ACE CONNECTOR WAS NOTED TO BE LEAKING FROM THE IRRIGATION PORT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 792576 | DALE ACE CONNECTOR | TUBES, GASTROINTESTINAL (AND ACCESSORIES) | KNT | DALE MEDICAL PRODUCTS, INC. | H84104751 | T14M68900 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 67 YR |