FDA Adverse Event Malfunction Summary report: N

GRASEBY MS26 SYRINGE DRIVER

MDR report key: 1901583 · Received November 10, 2010

Report

Report Number
2183502-2010-00533
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
September 13, 2010
Report Date
November 8, 2010
Manufacturer
SMITHS MEDICAL INTERNATIONAL LTD.
Product Code
FRN
PMA / PMN Number
K830151
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MFR FOR DEVICE EVAL. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MFR WILL FILE A F/U REPORT DETAILING THE RESULTS OF THE EVAL.

Description of Event or Problem · 1

USER FACILITY REPORTED THAT THE PUMP INFUSED MORE QUICKLY THAN PROGRAMMED. NO FURTHER DETAILS ARE AVAILABLE. NO ADVERSE EFFECTS TO PT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GRASEBY MS26 SYRINGE DRIVER FRN SMITHS MEDICAL INTERNATIONAL LTD. MS26 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK