FDA Adverse Event Injury Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 1665047 · Received April 19, 2010

Report

Report Number
1722139-2010-00051
Event Type
Injury
Date Received
April 19, 2010
Date of Event
March 31, 2010
Report Date
April 15, 2010
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
LZH
PMA / PMN Number
K031199
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

METHOD: ACTUAL DEVICE WAS EVALUATED. RESULTS: THE EVAL INCLUDED PERFORMANCE TESTING (ACCURACY, VERIFICATION OR AIR/NO FOOD ALARM, ETC). MULTIPLE FORMULAS AND SETTINGS WERE USED TO RECREATE THE FAILURE EXPERIENCED BY THE CUSTOMER. THE PUMP PERFORMED ACCORDING TO SPECIFICATION DURING EACH RUN (ALARMED AND SHUT OFF AFTER FOOD WAS GONE). CONCLUSION: THE ALLEGED COMPLAINT/DEFECT COULD NOT BE DUPLICATED. THE PUMP PERFORMED ACCORDING TO SPECIFICATION. THE DISPOSABLE SET USED AT THE TIME OF THE FAILURE WAS NOT RETURNED WITH THE PUMP AND COULD NOT BE EVALUATED. WE ARE ATTEMPTING TO CONTACT THE CUSTOMER/PT TO OBTAIN MORE INFO. IF MORE CUSTOMER/PT INFO BECOMES AVAILABLE, A FOLLOW UP REPORT MAY BE SUBMITTED.

Description of Event or Problem · 1

REPORTED BY THE CUSTOMER AS: PUMP CONTINUED TO PUMP AFTER FOOD WAS GONE. CUSTOMER STATED "PUMP KEEPS RUNNING WHEN BAG IS EMPTY." PT INJURY: NO.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENTERALITE INFINITY ENTERAL FEEDING PUMP LZH MOOG MEDICAL DEVICES GROUP INFINITY PUMP

Patients

Seq Age Sex Outcome Treatment
1