BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ACCLAIM ENCORE INFUSION PUMP

    MDR report key: 1950681 · Received December 29, 2010

    Report

    Report Number
    MW5018782
    Event Type
    Injury
    Date Received
    December 29, 2010
    Date of Event
    November 14, 2010
    Report Date
    December 29, 2010
    Manufacturer
    HOSPIRA
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    AFTER SETTING UP THE IV PUMP AND STARTING INFUSION, RN NOTED IV FLUID WAS NOT DRIPPING. THE PUMP WAS MAKING THE USUAL SOUND OF INFUSING AND THE IV FLUID VOLUME INFUSED NUMBER WAS INDICATED THAT FLUID WAS BEING INFUSED. DATES OF USE: (B)(6) 2010. DIAGNOSIS OR REASON FOR USE: PREGNANCY. INFUSION PUMP USED FOR IV FLUIDS AND IV ANTIBIOTICS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ACCLAIM ENCORE INFUSION PUMP INFUSION PUMP FRN HOSPIRA 12673983

    Patients

    Seq Age Sex Outcome Treatment
    1 28 YR Hospitalization