FDA Adverse Event Malfunction Summary report: N

ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM

MDR report key: 20333724 · Received September 30, 2024

Report

Report Number
3006575795-2024-00867
Event Type
Malfunction
Date Received
September 30, 2024
Date of Event
September 10, 2024
Report Date
September 30, 2024
Manufacturer
ZYNO MEDICAL, LLC
Product Code
FRN
UDI-DI
00814371020037
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 NO PREVIOUS COMPLAINTS ON THE DEVICE. 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 30 PSI VALUE (P.I) FAILED UNDER THE REQUIRED PARAMETERS AND NEEDED TO BE CALIBRATED. THE PUMP RECALIBRATED 30 PSI FROM 300 TO 280 CONFIRMED TO HAVE SUCCESSFULLY ADDRESSED THE ISSUE. A CAPA HAS BEEN OPENED IN ORDER TO FULLY INVESTIGATE AND ADDRESS THE ROOT CAUSE OF THE REPORTED EVENT. REFERENCE TO COMPLAINT#: (B)(4).

Description of Event or Problem · 0

ON 09/10/2024, ZNYO MEDICAL RECEIVED A REPORT THAT DURING THE PREVENTIVE MAINTENANCE (PM), THE DEVICE HAD FAILED THE 30 PSI TEST ALARMED AT 20.1 PSI. NO PATIENT WAS INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2582633 ZYNO MEDICAL Z-800 INFUSION PUMP SYSTEM LARGE VOLUME INFUSION PUMP FRN ZYNO MEDICAL, LLC Z800WF 201208256 00814371020037

Patients

Seq Age Sex Outcome Treatment
1 NA Prefer Not To Disclose