BARD? NASOGASTRIC SUMP TUBE WITH PREVENT? ANTI-REFLUX FILTER WITH ENFIT? 0046160

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other,user facility report with the FDA on 2020-02-21 for BARD? NASOGASTRIC SUMP TUBE WITH PREVENT? ANTI-REFLUX FILTER WITH ENFIT? 0046160 manufactured by C.r. Bard, Inc. (covington) -1018233.

Event Text Entries

[184145356] The investigation is still in progress. Once the investigation is complete, a supplemental report will be filed. The device was not returned.
Patient Sequence No: 1, Text Type: N, H10


[184145357] It was reported that the nurse noted a ng tube was leaking in between the air vent pigtail. The patient was admitted from the ed with the ng tube in place. A new 16fr ng tube was inserted after the leak was found.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1018233-2020-01229
MDR Report Key9739356
Report SourceOTHER,USER FACILITY
Date Received2020-02-21
Date of Report2020-03-10
Date of Event2019-12-13
Date Mfgr Received2020-03-04
Device Manufacturer Date2019-07-20
Date Added to Maude2020-02-21
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactYONIC ANDERSON
Manufacturer Street8195 INDUSTRIAL BLVD
Manufacturer CityCOVINGTON GA 30014
Manufacturer CountryUS
Manufacturer Postal30014
Manufacturer Phone7707846100
Manufacturer G1C.R. BARD, INC. (COVINGTON) -1018233
Manufacturer Street8195 INDUSTRIAL BLVD
Manufacturer CityCOVINGTON GA 30014
Manufacturer CountryUS
Manufacturer Postal Code30014
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBARD? NASOGASTRIC SUMP TUBE WITH PREVENT? ANTI-REFLUX FILTER WITH ENFIT?
Generic NameNASOGASTRIC TUBE
Product CodeFEG
Date Received2020-02-21
Model Number0046160
Catalog Number0046160
Lot NumberNGDT3047
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerC.R. BARD, INC. (COVINGTON) -1018233
Manufacturer Address8195 INDUSTRIAL BLVD COVINGTON GA 30014 US 30014


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-21

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