FDA Adverse Event Malfunction Summary report: N

ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM

MDR report key: 17564670 · Received August 17, 2023

Report

Report Number
3006575795-2023-00079
Event Type
Malfunction
Date Received
August 17, 2023
Report Date
August 16, 2023
Manufacturer
ZYNO MEDICAL, LLC
Product Code
FRN
PMA / PMN Number
K130690
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE FLOW RATE TEST WAS PERFORMED ON Z-800WF INFUSION PUMP, SERIAL NUMBER (B)(6) BY RUNNING THE FLOW RATE PROTOCOL IN THE ABOVE SECTION, THE ISSUE WAS NOT CONFIRMED THE PUMP PASSES WITH A 125.97 FLOWRATE ACCURACY AND A DEVIATION OF 0.13. THE PUMP WAS 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

A NURSE REPORTED THAT A PUMP WAS INFUSING FASTER THAN THE MACHINE WAS PROGRAMMED FOR. MEDICATION AND INFUSION PARAMTERS ARE UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1245496 ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM LARGE VOLUME INFUSION PUMP FRN ZYNO MEDICAL, LLC

Patients

Seq Age Sex Outcome Treatment
1 Unknown