BEUDAMED
    FDA Adverse Event Death Summary report: N

    ALARIS INFUSION PUMP

    MDR report key: 15986958 · Received December 14, 2022

    Report

    Report Number
    MW5113790
    Event Type
    Death
    Date Received
    December 14, 2022
    Date of Event
    November 28, 2022
    Report Date
    December 13, 2022
    Manufacturer
    CAREFUSION 303, INC.
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    BOTTLE SENSOR ERROR ON ALARIS PUMP LED TO THE WRONG MED BEING PROGRAMED INTO THE PUMP DUE TO THE RN SWITCHING THE CHANNELS FROM SIDE TO SIDE TO TROUBLESHOOT. PATIENT WAS DECOMPENSATING AT THE TIME OF THE RN ATTEMPTING TO TROUBLESHOOT THE ALARIS PUMP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1484909 ALARIS INFUSION PUMP PUMP, INFUSION FRN CAREFUSION 303, INC. 8015

    Patients

    Seq Age Sex Outcome Treatment
    1 66 YR Male Death| O