FDA Adverse Event
Malfunction
Summary report: N
CADD
MDR report key: 11842643
·
Received May 18, 2021
Report
- Report Number
- 3012307300-2021-04531
- Event Type
- Malfunction
- Date Received
- May 18, 2021
- Date of Event
- April 19, 2021
- Report Date
- May 18, 2021
- Manufacturer
- ST PAUL
- Product Code
- FPA
- UDI-DI
- 10610586027239
- PMA / PMN Number
- K040636
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
INFORMATION WAS RECEIVED REGARDING A CADD CASSETTE RESERVOIR. IT WAS REPORTED THAT THERE HAS BEEN AN INCREASE IN NO DISPOSABLE ALARMS WHILE USING LOTS 4092491 AND 4084027. THREE PATIENTS HAD A NO DISPOSABLE ALARM WITH LOT 4092491 AND 1 PATIENT HAD THE ALARM WITH 4094027. THERE WAS NO PATIENT, OR CLINICIAN INJURY ASSOCIATED WITH THIS OCCURRENCE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 738929 | CADD | INTRAVASCULAR ADMINISTRATION SET | FPA | ST PAUL | 21-7302-24 | 4084027 | 10610586027239 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |