FDA Adverse Event Malfunction Summary report: N

PERFUSOR®

MDR report key: 21813862 · Received April 10, 2025

Report

Report Number
9610825-2025-00209
Event Type
Malfunction
Date Received
April 10, 2025
Report Date
June 12, 2025
Manufacturer
B BRAUN MELSUNGEN AG
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN INTERNAL REPORT NUMBER (B)(4). A FOLLOW-UP REPORT WILL BE PROVIDED AFTER THE EXAMINATION RESULTS ARE AVAILABLE. PLEASE NOTE, THIS DEVICE IS DISTRIBUTED OUTSIDE THE US AND NO GUDID INFORMATION EXISTS. IT IS BEING REPORTED DUE TO A SIMILAR DEVICE BEING MARKETED WITHIN THE US WITH THE FOLLOWING INFO: UDI NUMBER (B)(4). PREMARKET SUBMISSION # K092313, K172831, K191910.

Additional Manufacturer Narrative · 0

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN INTERNAL REPORT NUMBER: (B)(4). PLEASE NOTE, THIS DEVICE IS DISTRIBUTED OUTSIDE THE US AND NO GUDID INFORMATION EXISTS. IT IS BEING REPORTED DUE TO A SIMILAR DEVICE BEING MARKETED WITHIN THE US WITH THE FOLLOWING INFO: UDI NUMBER: (B)(4), PREMARKET SUBMISSION #: K092313, K172831, K191910. NO SAMPLE WAS PROVIDED FOR EVALUATION. BASED ON THE DATA FROM THE INVESTIGATION WE ARE UNABLE TO DETERMINE THE ROOT CAUSE OF THE REPORTED INCIDENT. THE REPORTED DEFECT WAS UNABLE TO BE CONFIRMED. WE WILL MAINTAIN THIS REPORT FOR FURTHER REFERENCES AND CONTINUE TO MONITOR OTHER REPORTS FOR SIMILAR OCCURRENCES. IF ANY ADDITIONAL PERTINENT INFORMATION BECOMES AVAILABLE, A FOLLOW UP WILL BE SUBMITTED.

Description of Event or Problem · 0

ACCORDING TO THE EVENT DESCRIPTION: INCORRECT TIMING OF DRUG ADMINISTRATION. INFUSION ENDED 1.5 HOURS EARLIER THAN SCHEDULED IN FLOW SETTINGS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
492516 PERFUSOR® PUMP, INFUSION FRN B BRAUN MELSUNGEN AG 8713030

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown