FDA Adverse Event Malfunction Summary report: N

GEMSTAR 7 THERAPY PUMP

MDR report key: 1002611 · Received February 8, 2008

Report

Report Number
2921482-2008-00046
Event Type
Malfunction
Date Received
February 8, 2008
Date of Event
January 1, 2007
Report Date
January 15, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K023062
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AT THIS TIME THE CUSTOMER WILL NOT BE RETURNING THE DEVICE FOR EVALUATION. THE DEVICE PASSED TESTING AT THE USER FACILITY AND WAS RETURNED TO CLINICAL SERVICE.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THE DEVICE DELIVERED LESS SOLUTION THAN INTENDED. THE DEVICE WAS RETURNED TO THE USER FACILITY FROM THE HOMECARE PT'S HOME WITH A REPORT THAT THE DEVICE "UNDER INFUSED". NO SPECIFIC PT INFO, PUMP PROGRAMMING, OR EVENT DETAILS WERE PROVIDED. THERE WERE NO REPORTED ADVERSE PT EFFECTS. NO MEDICAL INTERVENTIONS WERE REPORTED. ON AN UNSPECIFIED DATE DURING TESTING AT THE USER FACILITY, THE DEVICE DELIVERED LESS THAN EXPECTED. IN 2008 DURING SUBSEQUENT TESTING, THE DEVICE PASSED TESTING. THOUGH REQUESTED, NO ADDITIONAL INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GEMSTAR 7 THERAPY PUMP 80-FRN FRN HOSPIRA, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNK