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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN 10FR 55 IRIS FEEDING TUBE ENF; GASTROINTESTINAL TUBES WITH ENTERAL SPECIFIC CONNECTORS

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COVIDIEN 10FR 55 IRIS FEEDING TUBE ENF; GASTROINTESTINAL TUBES WITH ENTERAL SPECIFIC CONNECTORS Back to Search Results
Model Number 461055E
Device Problem Fluid/Blood Leak (1250)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
The complainant indicated that the device will not be returned for evaluation; therefore, a failure analysis is not available, and we are not able to determine the relationship between this device and the cause for this event.If additional information or the sample is received, the investigation will be reopened and responded to accordingly.
 
Event Description
The customer reported that the ends (y-port) of the iris feeding tubes keep breaking.Some tubes are only lasting 2 days after placement into the patient.The customer believes this is due to the wire inside the tube not fitting with the peg ends and subsequently leaking.No patient injury was reported.New information received from the initial reporter on (b)(6) 2021 stated that the y-port at the end of the tubes split in the purple section between the two ports.This means the tubes leak, and can not be used.This seems to happen after 1-2 weeks of use.This is happening with a lot of tubes, to avoid having to replace the whole tube, they have cut the end of the tube off and inserted a standard replacement peg end.This allows them to continue using the tube.However the peg ends need repositioning every so often (cutting off a further 1-2cm of tube and reattaching the peg end), and they think this is because the tube can not mold properly to the peg end due to the internal wire (that powers the camera on the tip).This wire means the internal diameter of the tube is not completely circular, rendering the connection liable to leakage.
 
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Brand Name
10FR 55 IRIS FEEDING TUBE ENF
Type of Device
GASTROINTESTINAL TUBES WITH ENTERAL SPECIFIC CONNECTORS
Manufacturer (Section D)
COVIDIEN
15 hampshire street
mansfield MA 02048
Manufacturer (Section G)
COVIDIEN
15 hampshire street
mansfield MA 02048
Manufacturer Contact
jill saraiva
15 hampshire street
mansfield, MA 02048
5086183640
MDR Report Key11738214
MDR Text Key247766211
Report Number1282497-2021-10119
Device Sequence Number1
Product Code PIF
UDI-Device Identifier20884521742205
UDI-Public20884521742205
Combination Product (y/n)N
Reporter Country CodeUK
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 04/28/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator No Information
Device Model Number461055E
Device Catalogue Number461055E
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 08/05/2020
Initial Date FDA Received04/28/2021
Is the Device Single Use? Yes
Type of Device Usage N
Patient Sequence Number1
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