BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PLUM A

    MDR report key: 1870209 · Received September 20, 2010

    Report

    Report Number
    1870209
    Event Type
    Malfunction
    Date Received
    September 20, 2010
    Date of Event
    June 22, 2010
    Report Date
    July 6, 2010
    Manufacturer
    HOSPIRA
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AL, US

    Narratives

    Description of Event or Problem · 1

    PATIENT HOLDING ONTO IV POLE AS HE WAS BEING TRANSPORTED TO RADIOLOGY. IV PUMP SLID DOWN IV POLE HITTING PATIENT'S LEFT HAND. X-RAY REVEALED NO INJURY TO LEFT HAND.====================== HEALTH PROFESSIONAL'S IMPRESSION======================NO ADVERSE EVENT.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 17 YR NO OTHER THERAPIES