FDA Adverse Event Malfunction Summary report: N

OMNICELL I.V.STATION ONCO

MDR report key: 10273185 · Received July 14, 2020

Report

Report Number
3011278888-2020-00012
Event Type
Malfunction
Date Received
July 14, 2020
Date of Event
June 30, 2020
Report Date
May 20, 2021
Manufacturer
OMNICELL, INC.
Product Code
NEP
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

AS OF (B)(6) 2020, THE ESTABLISHMENT REGISTRATION AND LISTING FOR THIS DEVICE WAS UPDATED TO OMNICELL, INC. FROM AESYNT, INC, WHICH WAS NOT REFLECTED IN THE ORIGINAL REPORT SUBMISSION. THEREFORE, THIS REPORT IS A CORRECTION TO THE MANUFACTURER LISTED IN SECTIONS D3 AND G1.

Description of Event or Problem · 1

ON (B)(6) 2020 A SPILL INVOLVING THE CHEMOTHERAPY DRUG PREPARATION PACLITAXEL OCCURRED INSIDE THE I.V. STATION ONCO DEVICE. THE SPILL WAS IDENTIFIED AND SUBSEQUENTLY CLEANED BY THE USER. THE DRUG WAS SEEPING FROM THE LOADING SYRINGE CAUSING DRIPS TO ACCUMULATE ON THE BAG CLAMPS. MODIFICATIONS WERE MADE TO DRUG AND SYRINGE PRESSURE, VOLUME, SPEED AND TIME PARAMETERS TO PREVENT RECURRENCE OF THE DRIPPING. THERE IS NO ADVERSE PATIENT EFFECT RELATED TO THIS DRUG SPILL WITHIN THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
736571 OMNICELL I.V.STATION ONCO PHARMACY COMPOUNDING DEVICE NEP OMNICELL, INC. I.V. STATION ONCO

Patients

Seq Age Sex Outcome Treatment
1 Other