BEUDAMED
    FDA Adverse Event Death Summary report: N

    LEVIN TUBE

    MDR report key: 77910 · Received March 24, 1997

    Report

    Report Number
    MW1011003
    Event Type
    Death
    Date Received
    March 24, 1997
    Date of Event
    March 6, 1997
    Report Date
    March 20, 1997
    Manufacturer
    DAVOL INC. SUBSIDIARY OF CR BARD INC.
    Product Code
    FPD
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    3/6/97-N/G TUBE INSERTED 1430. TUBE FEEDING STARTED. 3/6/97-PT SOB,R-32 AT 2100. IPPB GIVEN, RR-24. 3/7/97 0500-70CC RESIDUAL OF TUBE FEEDING NGT CLAMPED. 1000-CHEST TUBE INSERTED. RIGHT PNEUMOTHORAX ON CHEST XRAY. NGT NOT RADIO OPAQUE. 3/8/97-1000-UGI GASTROGRAFIN ADMINISTERED PER NGT SHOWED NGT PASSED THROUGH TRACHEA AND R BRONCHUS WITH PERFORATION THROUGH THE LUNG AND PLEURA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LEVIN TUBE NASOGASTRIC TUBE, #16 FPD DAVOL INC. SUBSIDIARY OF CR BARD INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 80 YR Death