FDA Adverse Event Other Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 1705637 · Received May 28, 2010

Report

Report Number
1722139-2010-00061
Event Type
Other
Date Received
May 28, 2010
Date of Event
April 21, 2010
Report Date
May 27, 2010
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
LZH
PMA / PMN Number
K031199
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

METHOD - ACTUAL DEVICE WAS EVALUATED. RESULTS - THE EVALUATION INCLUDED PERFORMANCE TESTING (ACCURACY, VERIFICATION OF 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. WE ARE ATTEMPTING TO CONTACT THE CUSTOMER/PATIENT TO OBTAIN MORE INFORMATION. IF MORE CUSTOMER/PATIENT INFORMATION BECOMES AVAILABLE, A FOLLOW UP REPORT MAY BE SUBMITTED.

Description of Event or Problem · 1

REPORTED BY THE CUSTOMER AS: PUMP DID NOT ALARM AFTER FOOD WAS GONE. THE PUMP CONTINUED TO RUN AFTER FOOD WAS GONE. 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