FDA Adverse Event Injury Summary report: N

ALARIS PUMP MODULE ADMINISTRATION SET

MDR report key: 1053355 · Received May 28, 2008

Report

Report Number
9616066-2008-00017
Event Type
Injury
Date Received
May 28, 2008
Date of Event
April 24, 2008
Report Date
April 29, 2008
Manufacturer
CARDINAL HEALTH ALARIS PRODUCTS
Product Code
FPA
PMA / PMN Number
K022209
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PATIENT INFORMATION REQUESTED AND ALL AVAILABLE INFORMATION IS INCLUDED.

Description of Event or Problem · 1

FACILITY REPORTED THAT PATIENT WAS ON NITROPRUSSIDE DRIP FOR HYPERTENSION. BP IMPROVED, THEN PUMP ALARMED (ALARM MESSAGE NOT KNOWN), AND BP ROSE TOO HIGH. NURSE OPENED DOOR OF THE DEVICE AND FOUND CHANNEL WET WITH SMALL HOLE IN TUBING NEAR UPPER FITMENT. USER SWITCHED TUBING AND BP QUICKLY CAME BACK TO PREVIOUS LEVELS WITH NO OTHER INTERVENTION AND NO LONG TERM EFFECT ON PATIENT. FACILITY SENT SET FOR INVESTIGATION BUT IT HAS BEEN LOST IN SHIPPING. WILL FILE FOLLOW-UP REPORT IF SET IS RECEIVED IN THE FUTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALARIS PUMP MODULE ADMINISTRATION SET FPN, ADMINISTRATION SET FPA CARDINAL HEALTH ALARIS PRODUCTS 2420-0500 UNK

Patients

Seq Age Sex Outcome Treatment
1 78 YR Life Threatening| R ALARIS SYSTEM PCU AND LVP