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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN KANGAROO; PUMP, INFUSION, ENTERAL

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COVIDIEN KANGAROO; PUMP, INFUSION, ENTERAL Back to Search Results
Model Number 8884721088
Device Problems Difficult to Remove (1528); Device Contamination with Chemical or Other Material (2944)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Type  malfunction  
Manufacturer Narrative
The complainant indicated that the device will not be returned for evaluation; therefore, a failure analysis is not available, and we are not able to determine the relationship between this device and the cause for this event.If information is provided in the future, a supplemental report will be issued.
 
Event Description
The customer states that the stylet would not come out after the device was placed.The device was removed and replaced with a new ng tube without incident.
 
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Brand Name
KANGAROO
Type of Device
PUMP, INFUSION, ENTERAL
Manufacturer (Section D)
COVIDIEN
calle 9 sur no. 1113 cuidad
tijuana,na 22444
MX  22444
Manufacturer (Section G)
COVIDIEN
calle 9 sur no. 1113 cuidad
tijuana,na 22444
MX   22444
Manufacturer Contact
edward almeida
15 hampshire street
mansfield, MA 02048
5084524151
MDR Report Key7363010
MDR Text Key103271452
Report Number9612030-2018-00037
Device Sequence Number1
Product Code LZH
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,user f
Reporter Occupation Other
Type of Report Initial
Report Date 03/22/2018
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 Operator Health Professional
Device Model Number8884721088
Device Catalogue Number8884721088
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 01/08/2018
Initial Date FDA Received03/22/2018
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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