FDA Adverse Event Malfunction Summary report: N

PLUM A+ PUMP

MDR report key: 1170813 · Received September 15, 2008

Report

Report Number
2921482-2008-00287
Event Type
Malfunction
Date Received
September 15, 2008
Date of Event
August 21, 2008
Report Date
August 21, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K052052
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS REC'D. INVESTIGATION IS NOT COMPLETE. THE EVENT THAT IS BEING REPORTED WAS NOTED DURING VERIFICATION TESTING; THEREFORE, USER FACILITY EVENT CODES ARE NOT APPLICABLE IN THIS CASE.

Description of Event or Problem · 1

DURING VERIFICATION TESTING AT THE MFG FACILITY, THE DEVICE DID NOT ALARM WHEN AIR WAS PRESENT IN THE TUBING DISTAL TO THE CASSETTE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 NA PLUM A+ SOFTWARE MODULE