BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ANESTHESIA SYRINGE PUMP

    MDR report key: 15499004 · Received September 28, 2022

    Report

    Report Number
    MW5112304
    Event Type
    Injury
    Date Received
    September 28, 2022
    Date of Event
    September 2, 2022
    Report Date
    September 26, 2022
    Manufacturer
    UNK
    Product Code
    FRN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    SC, US
    Reporter Occupation
    501
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    AC INLET SOCKET ON BACK OF SYRINGE PUMP STARTED SPARKING AND SMOKING THEN STARTED FLAMING. ATLANTA BIOMEDICAL CORPORATION, (B)(4) US. FDA SAFETY REPORT ID # (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1616454 ANESTHESIA SYRINGE PUMP PUMP, INFUSION FRN UNK 4100

    Patients

    Seq Age Sex Outcome Treatment
    1 Prefer Not To Disclose Required Intervention