BEUDAMED
    FDA Adverse Event Death Summary report: N

    KANGAROO PET PUMP ONLY

    MDR report key: 1730844 · Received June 17, 2010

    Report

    Report Number
    1310379-2010-00010
    Event Type
    Death
    Date Received
    June 17, 2010
    Report Date
    June 10, 2010
    Manufacturer
    COVIDIEN
    Product Code
    LZH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED. DETECTIVE (B) (6) COULD NOT RELEASE ANY MORE DETAILS ABOUT THIS CASE OTHER THAN THE CURRENT COMPLAINT DESCRIPTION, AS THIS IS AN ONGOING POLICE INVESTIGATION. ACCORDINGLY, COVIDIEN IS LIMITED TO THE AMOUNT OF INFO AND DETAIL THAT IT HAS ACCESS TO.

    Description of Event or Problem · 1

    IT WAS REPORTED TO COVIDIEN ON (B) (6) 2010 THAT A CUSTOMER HAD AN ISSUE WITH AN ENTERAL FEEDING PUMP. THE CUSTOMER STATED, THE CHILD WAS ON THE PET PUMP BEFORE PASSING AWAY. DETECTIVE (B) (6) OF THE (B) (6) POLICE DEPARTMENT SAID THAT HE DOES NOT BELIEVE THE PUMP MALFUNCTIONED; HOWEVER, HE WANTED TO GET THE PUMP INVESTIGATED BY THE MFR, AS IT WAS INVOLVED WITH A PT'S DEATH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KANGAROO PET PUMP ONLY FEEDING PUMP LZH COVIDIEN 8884350300 Y0121614

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Death