FDA Adverse Event Malfunction Summary report: N

VOLUMAT MC AGILIA GB

MDR report key: 15801756 · Received November 15, 2022

Report

Report Number
3004548776-2022-00233
Event Type
Malfunction
Date Received
November 15, 2022
Date of Event
October 19, 2022
Report Date
April 12, 2023
Manufacturer
FRESENIUS VIAL S.A.S.
Product Code
FRN
Product Problem
Yes
Report Source
Distributor report
Reporter Location
UK
Reporter Occupation
OTHER
Health Professional
N

Narratives

Description of Event or Problem · 0

CUSTOMER REPORTS THE FOLLOWING: "COMPLAINT REPORT RECEIVED FROM STOCKPORT HOSPITAL TO REPORT PUMP OVER INFUSING. PUMP SERIAL NUMBER (B)(4) OVER INFUSED. 250MCG OF DIGOXIN ADMINISTERED AS PXB. VOLUMAT PUMP SET TO 50MLS OVER 1H20MINS. AFTER 10MINS ALL THE DIGOXIN HAD GONE THROUGH, DESPITE THE VOLUMAT PUMP STATING THAT IT HAD 57MINS LEFT WITH 35.3MLS LEFT TO RUN THROUGH. DEVICE TAKEN OUT OF USE. TO BE [SENT] TO FIELD SERVICE ENGINEER. " REPORTING DUE TO THE REFERENCED ISSUE; NO HARM TO PATIENT WAS REPORTED. MORE INFORMATION IS NEEDED TO COMPLETE THE INVESTIGATION.

Description of Event or Problem · 0

DEVICE HISTORY RECORD WAS REVIEWED. NO EVENT LINKED WITH THE REPORTED ISSUE WAS OBSERVED. PROVIDED HISTORY LOG IS FROM (22NOV2022 TO 11JAN2023 BUT REPORTED EVENT WAS ON 19OCT2022. DUE TO A LIMIT OF DOWNLOADABLE DATA WHICH IS 869 ELEMENTS THE REPORTED EVENT DATAS COULD NOT BE INCLUDED IN THE EXTRACTED HISTORY LOG. THEREFORE NO ANALYSIS COULD BE PERFORMED ON THE EVENT REPORTED DATE. THE REPORTED DEVICE WAS NOT RETURNED TO BRÉZINS FOR INVESTIGATION BUT WAS CHECKED LOCALLY. DUE TO THE UNABILITY TO GET THE HISTORY LOG DATAS FROM THE REPORTED EVENT DATE, THE CONDITION OF USE OF THE DEVICE REMAIN UNCLEAR. HOWEVER QUALITY CONTROL WAS PERFORMED AND NO TECHNICAL OR FUNCTIONAL ISSUE WAS OBSERVED AND THE INFORMATION THAT NO REPAIR WAS PERFORMED ON THE DEVICE WAS ALSO PROVIDED. THIS COMPLAINT IS CONSIDERED AS NOT VALID. FOR THIS ISSUE AS PER OUR LOCAL PROCEDURE, WE INITIATED NO ACTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
179184 VOLUMAT MC AGILIA GB INFUSION PUMP SYSTEM FRN FRESENIUS VIAL S.A.S.

Patients

Seq Age Sex Outcome Treatment
1 Unknown