BEUDAMED
    FDA Adverse Event Death Summary report: N

    INFUSOMAT

    MDR report key: 12706800 · Received October 27, 2021

    Report

    Report Number
    2532083-2021-00443
    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
    1600123 INFUSOMAT PUMP, INFUSION FRN B. BRAUN MELSUNGEN AG 8713051U 96990691I9 04046964660887

    Patients

    Seq Age Sex Outcome Treatment
    1 Death