BEUDAMED
    FDA Adverse Event Other Summary report: N

    ANDERSEN

    MDR report key: 715782 · Received May 12, 2006

    Report

    Report Number
    1053825-2006-00001
    Event Type
    Other
    Date Received
    May 12, 2006
    Date of Event
    April 10, 2006
    Manufacturer
    ANDERSEN PRODUCTS, INC.
    Product Code
    BSS
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SUCCESSFUL INSERTION OF ANDERSEN TUBE. STYLET BROKE APPROXIMATELY 4-5 INCHES FROM END OF TUBE WHEN ATTEMPTING TO REMOVE THE STYLET FROM THE NASOGASTRIC TUBE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANDERSEN NASOGASTRIC TUBE BSS ANDERSEN PRODUCTS, INC. AN 10.11 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other