BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CADD LEGACY PUMP

    MDR report key: 11634025 · Received April 7, 2021

    Report

    Report Number
    MW5100652
    Event Type
    Injury
    Date Received
    April 7, 2021
    Report Date
    March 8, 2021
    Manufacturer
    SMITHS MEDICAL ASD, INC
    Product Code
    FRN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    SPONTANEOUS CALL FROM (B)(6) HOSPITAL WEIGHT: (B)(6) KG, (B)(6) CALLED TO GET INFORMATION ON CURRENT DOSE. ALSO STATED THAT PATIENT WAS IN THE HOSPITAL DUE TO PUMP ISSUE (B)(6) DID NOT KNOW ANY FURTHER DETAILS. DID NOT PROVIDED PUMP SERIAL NUMBER. NO OTHER INFORMATION OR DATES PROVIDED. REPORTED TO (B)(6) BY: HEALTH PROFESSIONAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    523014 CADD LEGACY PUMP PUMP, INFUSION FRN SMITHS MEDICAL ASD, INC UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization