FDA Adverse Event
Malfunction
Summary report: N
SAPPHIRE INFUSION PUMP- ENGLISH
MDR report key: 14843036
·
Received June 28, 2022
Report
- Report Number
- 3010293992-2022-00011
- Event Type
- Malfunction
- Date Received
- June 28, 2022
- Report Date
- July 13, 2022
- Manufacturer
- EITAN MEDICAL LTD
- Product Code
- FRN
- UDI-DI
- 07290109150284
- PMA / PMN Number
- K192860
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IS
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
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: 3010293992.
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 ISRAEL: DELIVERY ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 909874 | SAPPHIRE INFUSION PUMP- ENGLISH | INFUSION PUMP | FRN | EITAN MEDICAL LTD | 07290109150284 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |