BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    72" 20 DEOP PRIMAY SET ROTATING LUER

    MDR report key: 1843467 · Received August 31, 2010

    Report

    Report Number
    1843467
    Event Type
    Malfunction
    Date Received
    August 31, 2010
    Date of Event
    August 24, 2010
    Report Date
    August 31, 2010
    Manufacturer
    ICU MEDICAL
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBING WOULD NOT ALLOW FLUIDS TO RUN. NEW TUBING WAS USED AND WORKED OK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 72" 20 DEOP PRIMAY SET ROTATING LUER INFUSION SET FPA ICU MEDICAL SF3040-20 1967971

    Patients

    Seq Age Sex Outcome Treatment
    1 *