FDA Adverse Event Other Summary report: N

ON-Q PAIN PUMP

MDR report key: 1872286 · Received September 8, 2010

Report

Report Number
2026095-2010-00138
Event Type
Other
Date Received
September 8, 2010
Date of Event
January 4, 2008
Report Date
December 28, 2009
Manufacturer
I-FLOW CORP.
Product Code
MEB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WAS RECEIVED FROM THE FDA, MEDWATCH (B)(4). AS NO CUSTOMER INFO WAS PROVIDED, NO FURTHER INFO COULD BE OBTAINED. WITHOUT THE CONTACT INFO, ACTUAL PRODUCT, LOT, OR SPECIFIC EVENT INFO, A COMPLETE ANALYSIS CANNOT BE CONDUCTED. AS NO LOT NUMBER WAS PROVIDED, THE DEVICE HISTORY RECORD AND THE LOT HISTORY CANNOT BE REVIEWED.

Description of Event or Problem · 1

MEDWATCH INDICATED INJURY THAT REQUIRED INTERVENTION TO THE SHOULDER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ON-Q PAIN PUMP ELASTOMERIC PUMP MEB I-FLOW CORP. UNK UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Other