MAUDE Adverse Event Report: CARDINAL HEALTH UNKNOWN ENTERAL ACCESS; TUBES, GASTROINTESTINAL (AND ACCESSORIES)

Model Number UNKNOWN ENTERAL ACCESS

Device Problem Obstruction of Flow (2423)

Patient Problem Insufficient Information (4580)

Event Type  malfunction  

Manufacturer Narrative

This complaint was received via an anonymous clinical study.Sample analysis could not be performed since samples were not provided for evaluation.This complaint will be used for trending and post market analysis.

Event Description

Per a post market clinical survey, the customer observed a clogged tube with the use of a neonatal/pediatric feeding tube.The customer stated there was a possible device relationship.This information was received via an anonymous post market clinical study; therefore, the customer information is unknown and no further information will be provided.

• Brand Name: UNKNOWN ENTERAL ACCESS
• Type of Device: TUBES, GASTROINTESTINAL (AND ACCESSORIES)
• Manufacturer (Section D): CARDINAL HEALTH; 777 west street; mansfield MA 02048
• Manufacturer (Section G): CARDINAL HEALTH; calle 9 sur no. 125 cuidad ind; tijuana 22500 ; MX 22500
• Manufacturer Contact: jill saraiva ; 777 west street; mansfield, MA 02048 ; 5086183640
• MDR Report Key: 16490478
• MDR Text Key: 311291695
• Report Number: 9612030-2023-03611
• Device Sequence Number: 1
• Product Code: KNT
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 03/06/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 03/06/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Model Number: UNKNOWN ENTERAL ACCESS
• Device Catalogue Number: UNKNOWN ENTERAL ACCESS
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 02/15/2023
• Is the Device Single Use?: No
• Type of Device Usage: A
• Patient Sequence Number: 1