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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: AVANOS MEDICAL INC. MIC GASTROSTOMY FEEDING TUBE WITH ENFIT CONNECTOR; DH EF BALLOON TUBES PRODUCTS

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AVANOS MEDICAL INC. MIC GASTROSTOMY FEEDING TUBE WITH ENFIT CONNECTOR; DH EF BALLOON TUBES PRODUCTS Back to Search Results
Model Number 8100-14LV
Medical Device Problem Codes Migration or Expulsion of Device (1395); Material Rupture (1546)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 01/24/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported, "we had another burst balloon last week - 3 days post insertion.Patient had 14fr mic bgt inserted as a new tube (b)(6) 2026.Patient called hotline due to tube falling out (b)(6) 2026.Attended a&e, enplug placed by a&e staff as it was the weekend enplug not placed all the way into the stoma, stoma had already closed halfway down.Patient required another rig insertion (b)(6) 2026." the stoma site was established (b)(6) 2026.
 
Additional Manufacturer Narrative
The actual complaint product was returned for evaluation.The device could not be filled with the suggested amount of water due to an apparent radial direction split of the balloon fabric at the proximal collar area of the device.The device history record for lot 30365085 was reviewed and the product was produced according to product specifications.A root cause could not be determined.All information reasonably known as of 27 feb 2026 has been included in this health authority report.Should additional information be obtained, a follow-up health authority report will be provided.The information provided by avanos medical inc.Represents all of the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to avanos medical inc.Avanos medical inc.Has no independent knowledge of the reported event but is relaying the information provided by the user facility where the incident occurred.This product incident is documented in the avanos medical complaint database and identified as complaint (b)(4).This information is submitted pursuant to 21cfr803, in compliance with the medical device reporting requirement and should not be considered to be an admission that an avanos medical inc.Product is defective or caused serious injury.
 
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Brand Name
MIC GASTROSTOMY FEEDING TUBE WITH ENFIT CONNECTOR
Common Device Name
DH EF BALLOON TUBES PRODUCTS
Manufacturer (Section D)
AVANOS MEDICAL INC.
5405 windward parkway
alpharetta GA 30004
Manufacturer (Section G)
AVENT SA DE R.L. DE C.V. (AVENT 1)
circuito industial no.40
colonia obrera
nogales, cp 84048
MX   84048
Manufacturer Contact
tamara cardona
5405 windward parkway
alpharetta, GA 30004
4704485487
MDR Report Key24470917
Report Number9611594-2026-00083
Device Sequence Number9581768
Product Code KNT
UDI-Device Identifier00350770442914
UDI-Public(01)00350770442914(240)120001492(11)250521(17)280520(10)30385035
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
K842076
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 02/27/2026
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
Operator of Device Health Professional
Device Model Number8100-14LV
Device Catalogue Number8100-14LV
Device Lot Number30365085
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/10/2026
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/28/2026
Initial Report FDA Received Date02/27/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/27/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient Age56 YR
Patient SexFemale
Patient Weight65 KG
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