FDA Adverse Event Malfunction Summary report: N

PLUM A+3 PUMP MEDNET WIRELESS

MDR report key: 1181088 · Received September 29, 2008

Report

Report Number
2921482-2008-00303
Event Type
Malfunction
Date Received
September 29, 2008
Date of Event
September 1, 2008
Report Date
September 10, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K052052
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THAT THE DEVICE DID NOT ALARM WHEN A DISTAL OCCLUSION WAS PRESENT. THIS WAS DUE TO A BROKEN DISTAL PRESSURE SENSOR PIN TIP.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTIVE MAINTENANCE TESTING AT THE USER FACILITY, THE DEVICE DID NOT ALARM WHEN A DISTAL OCCLUSION WAS PRESENT. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENTS WHILE THE DEVICE WAS IN CLINICAL USE. THOUGH REQUESTED, NO ADDITIONAL INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PLUM A+3 PUMP MEDNET WIRELESS 80-FRN FRN HOSPIRA, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA