FDA Adverse Event Malfunction Summary report: N

ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM

MDR report key: 20112830 · Received August 30, 2024

Report

Report Number
3006575795-2024-00699
Event Type
Malfunction
Date Received
August 30, 2024
Date of Event
August 8, 2024
Report Date
August 30, 2024
Manufacturer
ZYNO MEDICAL, LLC
Product Code
FRN
PMA / PMN Number
K130690
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THERE ARE PREVIOUS COMPLAINTS ON THE DEVICE NOT RELATED TO THE ISSUE. TESTING RESULTS WERE REVIEWED. IT WAS DISCOVERED THAT THERE WERE DISCREPANCIES IN THE TEST RECORDS. NCR #2024-018 HAD BEEN INITIATED TO ADDRESS THE DISCREPANCIES. THIS PUMP UNDERWENT ROUTINE MAINTENANCE TESTING BY "INTUVIE" PROVIDER WHERE IT WAS DETECTED THAT THE PUMP HAD PUMP ISSUE. REPLACING THE POWER SOURCE COMPONENT SUCCESSFULLY ADDRESSED THE ISSUE. A CAPA HAS BEEN OPENED TO FULLY INVESTIGATE AND ADDRESS THE ROOT CAUSE OF THE REPORTED EVENT. REFERENCE TO COMPLAINT # (B)(4).

Description of Event or Problem · 0

ON 08/08/2024, ZNYO MEDICAL RECEIVED A REPORT THAT DURING THE PREVENTIVE MAINTENANCE (PM), TO HAVE A POWER ISSUE. THE VALUE WAS 0.145-OHM, GREATER THAN THE STANDARD RATE 0.10-OHM. NO PATIENT WAS INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1006028 ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM LARGE VOLUME INFUSION PUMP FRN ZYNO MEDICAL, LLC Z800F 20110921-SH

Patients

Seq Age Sex Outcome Treatment
1 NA Prefer Not To Disclose