BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HOSPIRA

    MDR report key: 1802902 · Received August 10, 2010

    Report

    Report Number
    MW5017076
    Event Type
    Malfunction
    Date Received
    August 10, 2010
    Date of Event
    July 31, 2010
    Report Date
    August 10, 2010
    Manufacturer
    HOSPIRA
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A (B)(6) PREMATURE INFANT WAS RECEIVING TPN IV. THE IV PUMP SHUT ITSELF OFF WHILE CONNECTED TO ELECTRICITY/OUTLET. NO PT HARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOSPIRA PLUM A IV PUMP FRN HOSPIRA

    Patients

    Seq Age Sex Outcome Treatment
    1 1 MO Other