BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BLAKEMORE TUBE

    MDR report key: 439875 · Received January 24, 2003

    Report

    Report Number
    9610520-2003-00014
    Event Type
    Malfunction
    Date Received
    January 24, 2003
    Report Date
    January 24, 2003
    Manufacturer
    WILLY RUSCH AG
    Product Code
    KDH
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    HOLE IN LARGE BALLOON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BLAKEMORE TUBE ESOPHAGEAL KDH WILLY RUSCH AG NA 229222

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN