BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BD ALARIS 8100 LBP

    MDR report key: 11664098 · Received April 13, 2021

    Report

    Report Number
    MW5100772
    Event Type
    Injury
    Date Received
    April 13, 2021
    Date of Event
    April 11, 2021
    Report Date
    April 12, 2021
    Manufacturer
    BD / CAREFUSION 303, INC.
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    IV PUMP INFUSED 50ML BAG OF LASIX (500MG) IN TWO HOURS, PUMP SCREEN WAS RED AND FLASHING "PUMP FAILURE" ON SCREEN. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    555723 BD ALARIS 8100 LBP PUMP, INFUSION FRN BD / CAREFUSION 303, INC. ALARIS 8100 LBP EGF7482, MOD 8374

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Other| R