FDA Adverse Event Malfunction Summary report: N

ALARIS SYSTEM

MDR report key: 21136861 · Received January 13, 2025

Report

Report Number
2016493-2024-47081
Event Type
Malfunction
Date Received
January 13, 2025
Date of Event
December 18, 2024
Report Date
January 22, 2025
Manufacturer
CAREFUSION SD
Product Code
FRN
PMA / PMN Number
K133532
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: MANUFACTURER NARRATIVE. ROOT CAUSE: THE ROOT CAUSE FOR THE REPORTED ISSUE OF AN NUISANCE ALARMS WAS NOT DETERMINED BECAUSE NO PRODUCTS OR DEVICE LOGS WERE RETURNED.

Additional Manufacturer Narrative · 0

THE ACTUAL DATE OF EVENT IS UNKNOWN. A FOLLOW UP REPORT WILL BE SUBMITTED WITH INVESTIGATION RESULTS SHOULD THE DEVICE BE REPAIRED OR THE DEVICE/LOGS BE RECEIVED FOR EVALUATION. PER 803.52(F)(11)(III) THE INFORMATION PROVIDED REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. THE COMPLAINANT OR REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO THE MANUFACTURER.

Description of Event or Problem · 0

IT WAS REPORTED THROUGH NPS SURVEY THAT DEVICES CAN BE HARD TO PROGRAM DRIP RATES BECAUSE THE DEVICE BEEPS "INCESSANTLY" WITHOUT A CLEAR INDICATION OF WHAT IS WRONG MOST THE TIME. THERE WAS NO INFORMATION ON PATIENT INVOLVEMENT. ALTHOUGH REQUESTED, ADDITIONAL INFORMATION WAS NOT PROVIDED.

Description of Event or Problem · 0

IT WAS REPORTED THROUGH NPS SURVEY THAT DEVICES CAN BE HARD TO PROGRAM DRIP RATES BECAUSE THE DEVICE BEEPS "INCESSANTLY" WITHOUT A CLEAR INDICATION OF WHAT IS WRONG MOST THE TIME. THERE WAS NO INFORMATION ON PATIENT INVOLVEMENT. ALTHOUGH REQUESTED, ADDITIONAL INFORMATION WAS NOT PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
516500 ALARIS SYSTEM PUMP, INFUSION FRN CAREFUSION SD 8100

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown 8015.