BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SAKS VINE KIT

    MDR report key: 50878 · Received July 8, 1996

    Report

    Report Number
    50878
    Event Type
    Malfunction
    Date Received
    July 8, 1996
    Date of Event
    April 2, 1996
    Report Date
    April 5, 1996
    Manufacturer
    ROSS PRODUCTS DIV. ABBOTT LABORATORIES
    Product Code
    KNT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    PHALANGE AT THE END OF PEG DISCONNECTED; DISCOVERED WHEN TUBE REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAKS VINE KIT PEG TUBE KNT ROSS PRODUCTS DIV. ABBOTT LABORATORIES * *

    Patients

    Seq Age Sex Outcome Treatment
    1 98 YR Other