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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CARDINAL HEALTH 200, LLC CARDINAL HEALTH; TUBES, GASTROINTESTINAL (AND ACCESSORIES)

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CARDINAL HEALTH 200, LLC CARDINAL HEALTH; TUBES, GASTROINTESTINAL (AND ACCESSORIES) Back to Search Results
Model Number 8884710826E
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
An investigation is currently underway.Upon completion, the results will be forwarded.
 
Event or Problem Description
The customer reported that they had one documented and many other reported cases of tubes being found "fractured" on xray requiring immediate removal before risk of further complications.The tubes had no outward indications of any malfunction but was caught by radiology on xray for concern for fractured tube.
 
Additional Manufacturer Narrative
The device history record (dhr) could not be reviewed as no lot information was provided within the complaint.Prior to a lot¿s release, the lot must be deemed acceptable by passing inspections that are based on a valid sampling plan.During production, inspectors routinely examine a statistical sample both physically and visually.A physical sample was not returned for investigation, but a photo was provided.The photo was evaluated, and the reported condition was observed.Based on all available information, the root cause could not be determined at this time.¿we will continue to monitor related reports to determine if additional actions are necessary.
 
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Brand Name
CARDINAL HEALTH
Common Device Name
TUBES, GASTROINTESTINAL (AND ACCESSORIES)
Manufacturer (Section D)
CARDINAL HEALTH 200, LLC
3651 birchwood drive
waukegan IL 60085
Manufacturer (Section G)
CARDINAL HEALTH
calle 9 sur no. 125 cuidad ind
tijuana 22500
MX   22500
Manufacturer Contact
jill saraiva
3651 birchwood drive
waukegan, IL 60085
5086183640
MDR Report Key22656143
Report Number1423537-2025-00299
Device Sequence Number21016347
Product Code KNT
UDI-Device Identifier10192253011159
UDI-Public(01)10192253011159
Combination Product (Y/N)N
Initial Reporter StatePA
Initial Reporter CountryUS
PMA/510(K) Number
K112511
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility,Company Representative
Initial Reporter Occupation Nurse Practitioner
Type of Report Initial,Followup
Report Date (Section B) 09/08/2025
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 Model Number8884710826E
Device Catalogue Number8884710826E
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/14/2025
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date07/29/2025
Supplement Report FDA Received Date09/11/2025
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device A
Patient Sequence Number1
Patient SexUnknown
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