FDA Adverse Event Malfunction Summary report: N

PLUM XLMD PUMP

MDR report key: 1061943 · Received June 16, 2008

Report

Report Number
2921482-2008-00192
Event Type
Malfunction
Date Received
June 16, 2008
Date of Event
May 30, 2008
Report Date
June 2, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K010924
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTIVE MAINTENANCE TESTING AT THE USER FACILITY, THE DEVICE INTERMITTENTLY DID NOT SOUND AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION WHILE IN THE LOW VOLUME SETTING. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENTS WHILE THE DEVICE WAS IN CLINICAL USE. THOUGH REQUESTED, NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 NA