FDA Adverse Event Malfunction Summary report: N

PLUM A+ PUMP

MDR report key: 1241620 · Received November 19, 2008

Report

Report Number
2921482-2008-00380
Event Type
Malfunction
Date Received
November 19, 2008
Date of Event
October 28, 2008
Report Date
October 28, 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 RECEIVED. INVESTIGATION IS NOT COMPLETE. THE EVENT THAT IS BEING REPORTED WAS NOTED DURING MANUFACTURING TESTING; THEREFORE, USER FACILITY EVENT CODES ARE NOT APPLICABLE IN THIS CASE.

Description of Event or Problem · 1

DURING VERIFICATION TESTING AT THE MANUFACTURING FACILITY, THE DEVICE DELIVERED LESS THAN EXPECTED, AND DID NOT ALARM WHEN THE TUBING WAS CLAMPED DISTAL TO THE DEVICE.

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 LIST #12097| PLUM A+ SOFTWARE MODULE