FDA Adverse Event Other Summary report: N

CURLIN INFUSION 4000CMS IV PUMP

MDR report key: 1680181 · Received May 7, 2010

Report

Report Number
1722139-2010-00062
Event Type
Other
Date Received
May 7, 2010
Date of Event
April 7, 2010
Report Date
May 5, 2010
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
FRN
PMA / PMN Number
K981816
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

METHOD: ACTUAL DEVICE EVALUATED. STANDARD PERFORMANCE TESTS WERE COMPLETED. VISUAL INSPECTION PERFORMED. RESULTS: USER DID NOT FOLLOW INSTRUCTIONS TO HAVE PUMP CHECKED/TESTED AFTER BEING DAMAGED/DROPPED. CONCLUSION: DEVICE FOUND TO BE DAMAGED FROM ABUSE OR BEING DROPPED. THE DEVICE PLATEN (LATCH) WAS BENT, WHICH CAUSED THE DEVICE TO HAVE A FREE FLOW CONDITION.

Description of Event or Problem · 1

REPORTED BY THE CUSTOMER AS: DID 2 DAYS OF INFUSION IN 6 HOURS. CARDIAC DRUG WAS MILRINONE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURLIN INFUSION 4000CMS IV PUMP FRN MOOG MEDICAL DEVICES GROUP

Patients

Seq Age Sex Outcome Treatment
1 22 YR