FDA Adverse Event Malfunction Summary report: N

PLUM A+ PUMP

MDR report key: 1182344 · Received September 22, 2008

Report

Report Number
2921482-2008-00299
Event Type
Malfunction
Date Received
September 22, 2008
Date of Event
August 1, 2008
Report Date
September 2, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K052052
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THE PT RECEIVED MORE IV FLUID THAN INTENDED. THE PUMP WAS PROGRAMMED TO DELIVERY NORMAL SALINE AT A RATE OF 75 ML/HR WITH A VOLUME TO BE INFUSED (VTBI) OF 1000 ML AND THE DELIVERY WAS STARTED. THE CUSTOMER CONTACT REPORTED THAT APPROX 2.5-3 HOURS AFTER THE INITIATION OF THE DELIVERY, THE CONTAINER WAS REPORTEDLY EMPTY. THERE WERE NO ADVERSE PT EFFECTS. NO MEDICAL INTERVENTIONS WERE REQUIRED. DURING TESTING AT THE USER FACILITY, THE PUMP DELIVERED MORE THAN INTENDED. THOUGH REQUESTED, NO ADDITIONAL INFORMATION WAS PROVIDED.

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 67 YR PLUM A+ SOFTWARE MODULE