FDA Adverse Event Malfunction Summary report: N

PLUM XLMD PUMP

MDR report key: 1190722 · Received October 6, 2008

Report

Report Number
2921482-2008-00313
Event Type
Malfunction
Date Received
October 6, 2008
Date of Event
September 24, 2008
Report Date
September 24, 2008
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K010924
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

AT THIS TIME THE CUSTOMER WILL NOT BE RETURNING THE DEVICE FOR EVALUATION. IF THE DEVICE IS RECEIVED, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTIVE MAINTENANCE TESTING AT THE USER FACILITY, THE PUMP DID NOT SOUND AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION WHILE ON THE LOW VOLUME SETTING. 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 XLMD PUMP 80-FRN FRN HOSPIRA, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA