FDA Adverse Event Malfunction Summary report: N

CADD-LEGACY PLUS PUMP

MDR report key: 14138250 · Received April 18, 2022

Report

Report Number
3012307300-2022-06569
Event Type
Malfunction
Date Received
April 18, 2022
Report Date
April 18, 2022
Manufacturer
ST PAUL
Product Code
FRN
PMA / PMN Number
K982836
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

NO PRODUCT OR PHOTOGRAPHIC EVIDENCE WERE PROVIDED TO AID IN THIS INVESTIGATION. THE COMPLAINT REPORT OFFERED INSUFFICIENT DETAILS TO DETERMINE WHETHER THIS PRODUCT FUNCTIONED AS INTENDED OR WAS USED IN A MANNER CONSISTENT WITH ITS INSTRUCTIONS FOR USE (IFU) OR FAILED TO MEET PRODUCT SPECIFICATIONS. LACKING ANY ADDITIONAL EVIDENCE, THIS COMPLAINT HAS BEEN CLOSED AS UNCONFIRMED. IF THE PRODUCT IS RETURNED, SMITHS MEDICAL WILL REOPEN THIS COMPLAINT FOR FURTHER INVESTIGATION.

Additional Manufacturer Narrative · 0

NO PRODUCT OR PHOTOGRAPHIC EVIDENCE WERE PROVIDED TO AID IN THIS INVESTIGATION. THE COMPLAINT REPORT OFFERED INSUFFICIENT DETAILS TO DETERMINE WHETHER THIS PRODUCT FUNCTIONED AS INTENDED OR WAS USED IN A MANNER CONSISTENT WITH ITS INSTRUCTIONS FOR USE (IFU) OR FAILED TO MEET PRODUCT SPECIFICATIONS. LACKING ANY ADDITIONAL EVIDENCE, THIS COMPLAINT HAS BEEN CLOSED AS UNCONFIRMED. IF THE PRODUCT IS RETURNED, SMITHS MEDICAL WILL REOPEN THIS COMPLAINT FOR FURTHER INVESTIGATION.

Description of Event or Problem · 0

IT WAS REPORTED THAT CADD - LEGACY PLUS PUMP ALARMED NO DISPOSABLE, PUMP WON'T RUN. NO PATIENT INJURY REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT CADD - LEGACY PLUS PUMP ALARMED NO DISPOSABLE, PUMP WON'T RUN. NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
606017 CADD-LEGACY PLUS PUMP PUMP, INFUSION FRN ST PAUL 6500

Patients

Seq Age Sex Outcome Treatment
1 Female