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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBVIE MEDICAL DEVICE CENTRE DUODOPA_DUOPA; TUBES, GASTROINTESTINAL (AND ACCESSORIES)

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ABBVIE MEDICAL DEVICE CENTRE DUODOPA_DUOPA; TUBES, GASTROINTESTINAL (AND ACCESSORIES) Back to Search Results
Catalog Number 062918
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Aspiration Pneumonitis (4455)
Event Date 01/05/2024
Event Type  Injury  
Manufacturer Narrative
Reference record (b)(4).The device involved in the event remained implanted in the patient and was not returned; therefore, a return sample evaluation is unable to be performed.Catalog number in d4 is the similar us list number, the international list number is unknown.The device manufacturer and lot number of the device involved in this complaint was not provided.Therefore, it is unknown if the device involved was abbvie branded tubing.Conservatively, abbvie has chosen to report this complaint due to the potential that the device involved could have been abbvie branded tubing.Aspiration pneumonia is a known complication of a peg tube/ j-tube placement.If any further relevant information is identified or obtained, a supplemental medwatch will be filed.
 
Event Description
On (b)(6) 2024, a patient in germany underwent a procedure for the replacement of the jejunal (j) tube.On 05 jan 2024, the patient was hospitalized due to pneumonia.On (b)(6) 2024, the patient was discharged from the hospital.No further information was provided.
 
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Brand Name
DUODOPA_DUOPA
Type of Device
TUBES, GASTROINTESTINAL (AND ACCESSORIES)
Manufacturer (Section D)
ABBVIE MEDICAL DEVICE CENTRE
1675 south lakeside drive
waukegan
waukegan IL 60085
Manufacturer (Section G)
ABBVIE - MEDICAL DEVICE CENTER
1675 lakeside drive
waukegan IL 60085
Manufacturer Contact
terry ingram
1675 lakeside drive
waukegan, IL 60085
8479385350
MDR Report Key18676271
MDR Text Key335014980
Report Number3010757606-2024-00076
Device Sequence Number1
Product Code KNT
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K142793
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,Health Professional
Reporter Occupation Other Health Care Professional
Remedial Action Other
Type of Report Initial
Report Date 02/08/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/09/2024
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Lay User/Patient
Device Catalogue Number062918
Device Lot NumberUNKNOWN
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/12/2024
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
Treatment
UNKNOWN PEG TUBE, LOT # UNKNOWN
Patient Outcome(s) Required Intervention;
Patient Age83 YR
Patient SexMale
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