BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    USE

    MDR report key: 72934 · Received February 24, 1997

    Report

    Report Number
    72934
    Event Type
    Malfunction
    Date Received
    February 24, 1997
    Date of Event
    February 6, 1997
    Report Date
    February 18, 1997
    Manufacturer
    USE-GASTROTRAC
    Product Code
    KGC
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ON 2/6/97, JEJUNAL FEEDING TUBE WAS PLACED THROUGH A PT G-TUBE, WITHOUT EVENT. HOWEVER ON 2/14/97, PHYSICIAN REPORTED THAT THE J-TUBE SEPARATED FROM THE ADAPTER AND MIGRATED TO THE SM BOWEL. 2/14/94 X-RAY REVEALED J-TUBE IN STOMACH; REMOVED VIA ENDOSCOPY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 USE Implant FEEDING TUBE KGC USE-GASTROTRAC JEJUNAL TUBE 9402

    Patients

    Seq Age Sex Outcome Treatment
    1 26 YR