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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 8884721088E
Medical Device Problem Code Difficult to Remove (1528)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/27/2026
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported prior to placement, staff checked that the wire would move, as the charge nurse noted it can be difficult to remove the wire once placed.The wire was partially moved and then replaced.After the ng tube was placed, the wire would not come out.When the charge nurse pulled on it, the purple end came off.It sounds like staff worked for some time to remove the wire and were eventually able to do so.
 
Additional Manufacturer Narrative
An investigation is currently underway.Upon completion the results will be forwarded.
 
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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 Key25317687
Report Number1423537-2026-00173
Device Sequence Number20128944
Product Code KNT
UDI-Device Identifier10192253011753
UDI-Public(01)10192253011753
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K833621
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 06/30/2026
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
Device Model Number8884721088E
Device Catalogue Number8884721088E
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/27/2026
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date05/28/2026
Supplement Report FDA Received Date06/30/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
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 A
Patient Sequence Number1
Patient SexUnknown
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