FDA Adverse Event
Malfunction
Summary report: N
SAPPHIRE INFUSION PUMP- ENGLISH
MDR report key: 12849865
·
Received November 21, 2021
Report
- Report Number
- 3010293992-2021-00057
- Event Type
- Malfunction
- Date Received
- November 21, 2021
- Date of Event
- October 28, 2021
- Report Date
- December 21, 2021
- Manufacturer
- EITAN MEDICAL LTD
- Product Code
- FRN
- PMA / PMN Number
- K192860
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IS
- Reporter Occupation
- NURSE
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
EITAN MEDICAL LTD IS FORMERLY NAMED Q CORE MEDICAL LTD. (B)(4).
Additional Manufacturer Narrative · 0
EITAN MEDICAL LTD IS FORMERLY NAMED Q CORE MEDICAL LTD. THE FEI NUMBER IS THE SAME (B)(4).
Additional Manufacturer Narrative · 0
EITAN MEDICAL LTD IS FORMERLY NAMED Q CORE MEDICAL LTD. THE FEI NUMBER IS THE SAME (B)(4).
Description of Event or Problem · 0
THE COMPLAINT WAS REPORTED BY A CUSTOMER FROM (B)(6): DELIVERY ISSUE.
Description of Event or Problem · 0
THE COMPLAINT WAS REPORTED BY A CUSTOMER FROM (B)(6) : DELIVERY ISSUE.
Description of Event or Problem · 0
THE COMPLAINT WAS REPORTED BY A CUSTOMER FROM (B)(6): DELIVERY ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1747857 | SAPPHIRE INFUSION PUMP- ENGLISH | INFUSION PUMP | FRN | EITAN MEDICAL LTD |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |