FDA Adverse Event Malfunction Summary report: N

ON-Q

MDR report key: 1933921 · Received December 10, 2010

Report

Report Number
1933921
Event Type
Malfunction
Date Received
December 10, 2010
Date of Event
November 30, 2010
Report Date
December 10, 2010
Manufacturer
I-FLOW CORPORATION
Product Code
MEB
Product Problem
Yes
Report Source
User Facility report
Reporter Location
MI, US

Narratives

Description of Event or Problem · 1

PT HAS AN ON-Q PAIN PUMP. PUMP LEAKED SEVERELY THROUGH THE CONTROL DIAL TO THE POINT THAT THE LINENS ON THE BED HAD TO BE CHANGED. PUMP WAS CHANGED OUT. THIS WAS A 400ML PAIN PUMP, MODEL #CB004, LOT #082236.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ON-Q PUMP, INFUSION, ELASTOMERIC MEB I-FLOW CORPORATION CB004 082236

Patients

Seq Age Sex Outcome Treatment
1 *