BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HOSPIRA INFUSION PUMP

    MDR report key: 1950813 · Received April 20, 2010

    Report

    Report Number
    MW5018812
    Event Type
    Malfunction
    Date Received
    April 20, 2010
    Date of Event
    April 17, 2010
    Report Date
    April 20, 2010
    Manufacturer
    HOSPIRA INC.
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT IN THE INFUSION CENTER TO RECEIVE IV ANTIBIOTICS ON (B)(6) 2010. VANCOMYCIN ADMINISTERED VIA HOSPIRA PUMP THAT WAS PROGRAMMED FOR 265CC. PUMP STARTED TO ALARM, INFUSION WAS COMPLETE, BUT THERE WAS STILL SOME FLUID IN THE VANCOMYCIN BAG. AN ADD'L 30CC WAS PROGRAMMED IN THE PUMP. WHEN GOING BACK TO CHECK ON THE INFUSION, THE TUBING WAS NOTED TO HAVE AIR IN IT AT A GOOD DISTANCE FROM THE AIR SENSOR. THIS HAD NOT REACHED THE PT. THE INFUSION WAS STOPPED AND LINE FLUSHED. THE AIR SENSOR DID NOT WORK. NO HARM CAME TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOSPIRA INFUSION PUMP HOSPIRA INFUSION PUMP FRN HOSPIRA INC. 16026-04-57

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR