FDA Adverse Event Malfunction Summary report: N

ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM

MDR report key: 18983169 · Received March 26, 2024

Report

Report Number
3006575795-2024-00064
Event Type
Malfunction
Date Received
March 26, 2024
Date of Event
March 8, 2024
Report Date
May 14, 2024
Manufacturer
ZYNO MEDICAL, LLC
Product Code
FRN
UDI-DI
00814371020037
PMA / PMN Number
K130690
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

THIS FOLLOW UP MDR REPORT IS A CORRECTION OF INITIAL REPORT 3006575795-2024-00064. THE INTIIAL REPORT HAD THE INCORRECT DATE RECEIVED BY MANUFACTURER OF MARCH 8, 2024. THE CORRECT DATE RECEIVED BY MANUFACTURER IS MARCH 11, 2024. THIS DATE IS REFLECTED IN THE PRODUCT COMPLAINT (2024-264). ALL OTHER INFORMATION PROVIDED IN THE INITIAL REPORT IS ACCURATE.

Additional Manufacturer Narrative · 0

ON 03/08/2024, DURING A SERVICING ACTIVITIES OF ZYNO MEDICAL DEVICES, INCLUDING PREVENTIVE MAINTENANCE, THIS PUMP WITH S/N (B)(6) WAS FOUND TO HAVE: FLOW RATE OFFSET %, -1, 5 B.F.

Description of Event or Problem · 0

DURING SERVICING ACTIVITIES OF ZYNO MEDICAL DEVICES, INCLUDING PREVENTIVE MAINTENANCE, THIS PUMP WITH S/N (B)(6) WAS ALLEGED TO HAVE: FLOW RATE OFFSET %, -1, 5 B.F.ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
493170 ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM LARGE VOLUME INFUSION PUMP, FRN ZYNO MEDICAL, LLC Z800 201016280 00814371020037

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown