FDA Adverse Event Malfunction Summary report: N

DELTEC COZMO INSULIN PUMP

MDR report key: 1080112 · Received July 17, 2008

Report

Report Number
2183502-2008-00188
Event Type
Malfunction
Date Received
July 17, 2008
Date of Event
June 18, 2008
Report Date
July 15, 2008
Manufacturer
SMITHS MEDICAL MD (FORMERLY DELTEC, INC)
Product Code
LZG
Removal / Correction Number
2183502-03/10/08-005-R
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MFR FOR DEVICE EVAL. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MFR WILL FILE A F/U REPORT DETAILING THE RESULTS OF THE EVAL.

Description of Event or Problem · 1

THE RPTR CALLED FOR A REPLACEMENT DEVICE DUE TO SUSPECTED DELIVERY ISSUES. THERE WAS NO PT INJURY OR TREATMENT ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DELTEC COZMO INSULIN PUMP INSULIN PUMP LZG SMITHS MEDICAL MD (FORMERLY DELTEC, INC) 1800 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK