BEUDAMED
    FDA Adverse Event Death Summary report: N

    CORPAK MED SYSTEMS

    MDR report key: 462402 · Received May 27, 2003

    Report

    Report Number
    462402
    Event Type
    Death
    Date Received
    May 27, 2003
    Date of Event
    April 24, 2003
    Report Date
    May 15, 2003
    Manufacturer
    CORPAK MED SYSTEMS
    Product Code
    FPD
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WITH SPINA FIBIDA AND CHIARI II MALFORMATION. NJT INSERTED FOR NUTRITIONAL SUPPORT-TUBE CURLED ON THE NEXT DAY PNEUMOTHORAX NOTED. 05/03/2003 PATIENT EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORPAK MED SYSTEMS 8FR.36 " NJT ENTERAL DEVICE WITH STYLETTE FPD CORPAK MED SYSTEMS UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 20 YR Death