inforMED
InjuryGBW

MALECOT

Received Jun 26, 2013 · Event occurred May 28, 2013

Report 2134265-2013-04337 · MDR key 3191465

Device

Generic name

Catheter, Peritoneal

Model number

M001224110

Catalog number

22-411

Lot number

0015714630

Product problems

  • Break

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

DEVICE EVALUATED BY MFR: IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE, A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Description of Event or Problem

IT WAS REPORTED THAT DURING A UNSPECIFIED PROCEDURE DEVICE BREAKAGE OCCURRED. A MALECOT CATHETER HAD BEEN ADVANCED AND AT AN UNSPECIFIED TIME, THE DISTAL PORTION OF THE CATHETER BROKE OFF IN THE PATIENT'S STOMACH. A GASTROSTOMY WAS PERFORMED. NO ADDITIONAL PATIENT COMPLICATIONS WERE REPORTED AND THE PATIENT'S STATUS IS STABLE