FDA Adverse Event Malfunction Summary report: N

OMNICELL I.V.STATION ONCO

MDR report key: 10332186 · Received July 28, 2020

Report

Report Number
3011278888-2020-00014
Event Type
Malfunction
Date Received
July 28, 2020
Date of Event
July 9, 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
OTHER

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 A CHEMOTHERAPY DRUG PREPARATION OCCURRED INSIDE THE I.V. STATION ONCO DEVICE. THE SPILL OCCURRED DURING VIAL WITHDRAWAL OR INJECTION INTO THE BAG AND MAY BE ATTRIBUTED TO CONSUMABLES. THE ISSUE WAS NOT ABLE TO BE REPRODUCED. NO DEVICE MODIFICATIONS WERE MADE AND THE ISSUE HAS NOT RECURRED. THE SPILL WAS IDENTIFIED AND SUBSEQUENTLY CLEANED BY THE USER. 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
797726 OMNICELL I.V.STATION ONCO PHARMACY COMPOUNDING DEVICE NEP OMNICELL, INC. I.V. STATION ONCO

Patients

Seq Age Sex Outcome Treatment
1 Other