FDA Adverse Event Death Summary report: N

INFUSOMAT

MDR report key: 12706706 · Received October 27, 2021

Report

Report Number
2532083-2021-00444
Event Type
Death
Date Received
October 27, 2021
Date of Event
September 23, 2021
Report Date
October 27, 2021
Manufacturer
B. BRAUN MELSUNGEN AG
Product Code
FRN
UDI-DI
04046964660887
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
LA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN MEDICAL INC. INTERNAL REPORT NUMBER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1600939 INFUSOMAT PUMP, INFUSION FRN B. BRAUN MELSUNGEN AG 8713051U 96990691I9 04046964660887

Patients

Seq Age Sex Outcome Treatment
1 Death