FDA Adverse Event Malfunction Summary report: N

CADD CASSETTE 100ML W/FLOWSTOP

MDR report key: 14194957 · Received April 22, 2022

Report

Report Number
MW5109321
Event Type
Malfunction
Date Received
April 22, 2022
Date of Event
April 12, 2022
Report Date
April 12, 2022
Manufacturer
SMITHS MEDICAL ASD, INC.
Product Code
LHI
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
IN, US
Reporter Occupation
PHARMACIST
Health Professional
Yes

Narratives

Description of Event or Problem · 0

INBOUND. PATIENT REPORTS NO DISPOSABLE ALARM ON BOTH PUMPS WHILE USING CADD 100 ML CASSETTE WITI-L FLOW STOP LOT NUMBER 4230866, EXPIRATION DATE 12/27/2026. NO FURTHER DETAILS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1792449 CADD CASSETTE 100ML W/FLOWSTOP SET, I.V. FLUID TRANSFER LHI SMITHS MEDICAL ASD, INC. 4230866
1792450 CADD PUMP PUMP, INFUSION LHI SMITHS MEDICAL ASD, INC.
1792451 CADD PUMP PUMP, INFUSION LHI SMITHS MEDICAL ASD, INC.

Patients

Seq Age Sex Outcome Treatment
1 55 YR Female