FDA Adverse Event Malfunction Summary report: N

PLMA DVC V11. 51 1 N

MDR report key: 1883135 · Received October 19, 2010

Report

Report Number
2921482-2010-00797
Event Type
Malfunction
Date Received
October 19, 2010
Date of Event
September 20, 2010
Report Date
September 21, 2010
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K070398
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL. (B)(4).

Description of Event or Problem · 1

DURING TESTING AT THE USER FACILITY, IT WAS NOTED THAT THE PUMP COULD BE PROGRAMMED WHEN THE LOCKOUT SWITCH WAS PLACED IN THE LOCKED POSITION. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS AND NO REPORTED DELAYS OF CRITICAL THERAPIES WHILE THE PUMP WAS IN CLINICAL USE. THOUGH REQUESTED, NO ADDITIONAL INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PLMA DVC V11. 51 1 N 80FRN FRN HOSPIRA, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA PLUM A+ SOFTWARE MODULE: LIST #12097 (B)(4)