SALEM SUMP ANTI-REFLUX VALVE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-24 for SALEM SUMP ANTI-REFLUX VALVE manufactured by Cardinal Health 200, Llc.

Event Text Entries

[184659817] Multiple nurses have had issues with anti-reflux valves breaking. Nursing has to pull out broken pieces with hemostats or pliers from the ng tube.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9871612
MDR Report Key9871612
Date Received2020-03-24
Date of Report2020-03-11
Date of Event2020-03-01
Report Date2020-03-11
Date Reported to FDA2020-03-11
Date Reported to Mfgr2020-03-24
Date Added to Maude2020-03-24
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSALEM SUMP ANTI-REFLUX VALVE
Generic NameTUBES, GASTROINTESTINAL (AND ACCESSORIES)
Product CodeKNT
Date Received2020-03-24
Lot Number1805086964
Device AvailabilityN
Device Age1 DA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCARDINAL HEALTH 200, LLC
Manufacturer Address785 FORT MILL HWY FORT MILL SC 29707 US 29707


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-24

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