FDA Adverse Event Malfunction Summary report: N

PATROL

MDR report key: 1912415 · Received November 29, 2010

Report

Report Number
1912415
Event Type
Malfunction
Date Received
November 29, 2010
Date of Event
November 26, 2010
Report Date
November 29, 2010
Manufacturer
ABBOTT NUTRITION (ROSS PRODUCTS)
Product Code
LZH
Product Problem
Yes
Report Source
User Facility report
Reporter Location
AZ, US

Narratives

Description of Event or Problem · 1

THE PATIENT HAS A METABOLIC PROTEIN DEGRADATION PROBLEM AND CAME IN WITH HIGH AMMONIA LEVEL. SHE HAS CONTINUOUS G-TUBE FEEDS THAT HAVE A SPECIFIC AMOUNT OF PROTEIN AND PROTEIN SCAVENGERS. THE PUMP ALARMED "DOSE FED" AND THERE WAS STILL A LOT IN THE BAG. THE VOLUME WAS RESET TO INFUSE MORE AND IT BEEPED IN ANOTHER COUPLE OF HOURS, BUT THE VOLUME IN THE BAG REMAINED THE SAME. THE FEEDING TUBE WAS TAKEN APART AND THE PATIENT'S EXTENSION WAS FULLY CLOTTED. THE PUMP ONLY SAID "DOSE FED." THIS PUMP IS TO HAVE A "MALFUNCTION" STATEMENT, WHICH DID NOT ALARM OR NOTIFY STAFF. PATIENT REQUIRED MONITORING, BUT NO LONG-TERM ADVERSE OUTCOME TO DATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PATROL PUMP, INFUSION, ENTERAL LZH ABBOTT NUTRITION (ROSS PRODUCTS) * *

Patients

Seq Age Sex Outcome Treatment
1 7 YR