FDA Adverse Event Malfunction Summary report: N

EASYPUMP

MDR report key: 2043334 · Received February 25, 2011

Report

Report Number
2026095-2011-00046
Event Type
Malfunction
Date Received
February 25, 2011
Date of Event
April 10, 2008
Report Date
June 30, 2008
Manufacturer
I-FLOW CORPORATION
Product Code
MEB
PMA / PMN Number
K063530
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

A DEVICE HISTORY RECORD WAS CONDUCTED, AND ALL MANUFACTURING OPERATIONS WERE FOUND TO BE WITHIN SPECIFICATION. A REVIEW OF THE LOT 772074 HISTORY FOUND NO CONFIRMED COMPLAINTS OF FAST FLOW FOR THE LOT REPORTED. I-FLOW RECEIVED ONE EMPTY AND USED SAMPLE FOR EVALUATION AND INVESTIGATION. THE PUMP WAS REFILLED WITH NORMAL SALINE SOLUTION TO THE FILL VOLUME OF 60ML AND A FLOW RATE ACCURACY TEST WAS PERFORMED. THE FLOW RATE ACCURACY WAS WITHIN SPECIFICATION. IN ADDITION, RETAIN SAMPLES FROM LOT 772074 WERE TESTED. THE PUMPS WERE FILLED WITH NORMAL SALINE SOLUTION TO THE NOMINAL FILL VOLUME OF 60 ML AND A FLOW RATE ACCURACY TEST WAS PERFORMED. THE FLOW ACCURACY TEST RESULTS WERE FOUND TO BE WITHIN SPECIFICATION. PRODUCT COMPLAINT WAS NOT CONFIRMED.

Description of Event or Problem · 1

(DRUG/DILUENT: SANDOSTATINE 300 NG 30ML + 30ML OF NACL). FLOW RATE TOO FAST. (FILL VOLUME: 60ML AND FLOW RATE: 2ML/HR). INFUSED IN 16 HOURS INSTEAD OF 24 HOURS. NO ADVERSE EVENT OCCURRED. DATE OF EVENT: (B)(6) 2008.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EASYPUMP ELASTOMERIC PUMP MEB I-FLOW CORPORATION LT 60-24 772074

Patients

Seq Age Sex Outcome Treatment
1 UNK