FDA Adverse Event Malfunction Summary report: N

ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM

MDR report key: 17390009 · Received July 25, 2023

Report

Report Number
3006575795-2023-00064
Event Type
Malfunction
Date Received
July 25, 2023
Report Date
July 25, 2023
Manufacturer
ZYNO MEDICAL, LLC
Product Code
FRN
UDI-DI
00814371020013
PMA / PMN Number
K130690
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THE FLOWRATE TEST WAS PERFORMED ON Z-800F INFUSION PUMP, SERIAL NUMBER (B)(6) BY RUNNING FLOWRATE TESTING PROTOCOL IN THE ABOVE SECTION, THE ISSUE WAS NOT CONFIRMED THE FLOWRATE WAS 118.94 AND THE DEVIATION WAS -2.61 THE PUMP IS OPERATING WITHIN SPECIFICATIONS.

Additional Manufacturer Narrative · 0

RETURN OF THE DEVICE HAS BEEN REQUESTED. AS OF THE DATE OF THIS REPORT, DEVICE HAS NOT BEEN RETURNED.

Description of Event or Problem · 0

HEALTHCARE PROFESSIONAL REPORTED "ISSUES WITH NOT INFUSING". MEDICATION BEING INFUSED WAS UNKNOWN. NO PATIENT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2344840 ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM LARGE VOLUME INFUSION PUMP FRN ZYNO MEDICAL, LLC Z-800F 170412400 00814371020013

Patients

Seq Age Sex Outcome Treatment
1 Unknown