FDA Adverse Event Malfunction Summary report: N

GRASEBY MS 26 SYRINGE DRIVER

MDR report key: 1841323 · Received September 16, 2010

Report

Report Number
2183502-2010-00395
Event Type
Malfunction
Date Received
September 16, 2010
Report Date
September 9, 2010
Manufacturer
SMITHS MEDICAL INTERNATIONAL, LTD.
Product Code
FRN
PMA / PMN Number
K830151
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RECEIVED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.

Description of Event or Problem · 1

USER FACILITY REPORTED THAT THE PUMP INFUSED MORE QUICKLY THAN PROGRAMMED. NO FURTHER DETAILS ARE AVAILABLE. NO ADVERSE EFFECTS TO PATIENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GRASEBY MS 26 SYRINGE DRIVER FRN - SYRINGE INFUSION PUMP FRN SMITHS MEDICAL INTERNATIONAL, LTD. MS 26 UNK

Patients

Seq Age Sex Outcome Treatment
1