BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANDERSEN

    MDR report key: 483219 · Received September 10, 2003

    Report

    Report Number
    1053825-2003-00001
    Event Type
    Other
    Date Received
    September 10, 2003
    Date of Event
    August 15, 2003
    Report Date
    September 5, 2003
    Manufacturer
    ANDERSEN PRODUCTS, INC.
    Product Code
    BSS
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    AN AN10 NASOGASTRIC TUBE HAD BEEN INSERTED. WHEN REMOVED, THE PATIENT REPORTED THAT THE TUBE HAS "KNOTTED ON THE END AND WHEN REMOVED CAUSED THEIR NOSE TO HEMORRHAGE." NO FURTHER INFORMATION WAS AVAILABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANDERSEN NASOGASTRIC TUBE BSS ANDERSEN PRODUCTS, INC. AN10.00 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other