FDA Adverse Event Malfunction Summary report: N

IVENIX LARGE VOLUME INFUSION PUMP

MDR report key: 19388119 · Received May 23, 2024

Report

Report Number
3014732157-2024-00239
Event Type
Malfunction
Date Received
May 23, 2024
Date of Event
March 14, 2022
Report Date
May 23, 2024
Manufacturer
FRESENIUS KABI USA, LLC
Product Code
FRN
PMA / PMN Number
K183311
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

THE FOLLOWING HAS BEEN REPORTED: PUMP FOUND IN OFFICE WITH CARTRIDGE ERROR REPORTED, DID HARD SHUT DOWN, RAN TEST INFUSION, ADMIN SET ERROR APPEARED ON SCREEN, I CLEARED ERROR AND IT DID NOT RETURN. DID NOT DOWNLOAD LOGS. A REVIEW OF THE LOGS HAS ALLOWED FRESENIUS KABI ENGINEERING TO REVIEW AND IDENTIFY THE FOLLOWING ISSUE: INLET VALVE ACTUATOR-IMPROPER MOVEMENT COMMAND REPORTING DUE TO REFERENCED ISSUE. NO ADVERSE EFFECTS WERE REPORTED. THE DEVICE WAS RECEIVED BACK FOR INVESTIGATION. FLUID VALVE ASSEMBLY WAS UNABLE TO OPERATE AS INTENDED DURING STARTUP CHECK, CAUSING A PUMP PROBLEM ALARM TO BE RAISED. INTERMITTENT OPERATION OF THE FLUID VALVE ACTUATOR. EACH OF THE VALVES ARE MONITORED BY SENSORS TO VERIFY THAT THEY HAVE BEEN PULLED TO THE CORRECT OPEN POSITION. THE PUMP CORRECTLY IDENTIFIED THIS INABILITY, AND ALARMED AS EXPECTED. CONCLUSION: FVA PINS WERE NOT ABLE TO REACH THEIR TARGET DESTINATIONS DURING OPERATION DUE TO TORQUE LOSSES IN THE SYSTEM. ROOT CAUSE: INCORRECTLY INSTALLED WAVE SPRING (55-1595) IN FVA ASSEMBLY 20-0032. FRESENIUS KABI HAS PERFORMED A RETROSPECTIVE REVIEW OF COMPLAINTS ASSOCIATED WITH THIS FAILURE MODE AND HAS DECIDED TO SUBMIT AN MDR SUBMISSION AS A CONSERVATIVE MEASURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1863311 IVENIX LARGE VOLUME INFUSION PUMP INFUSION PUMP SYSTEM FRN FRESENIUS KABI USA, LLC

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown