BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CURLIN ADMINISTRATION SET

    MDR report key: 2191822 · Received July 29, 2011

    Report

    Report Number
    1722139-2011-00171
    Event Type
    Malfunction
    Date Received
    July 29, 2011
    Date of Event
    October 10, 2010
    Report Date
    October 10, 2010
    Manufacturer
    MOOG MEDICAL DEVICES GROUP
    Product Code
    FRN
    Removal / Correction Number
    Z-1440-2011
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    PRODUCT 340-4114 IS CURRENTLY UNDER RECALL #Z-1440-2011.

    Description of Event or Problem · 1

    INFO RECEIVED ALLEGES THE ACCOUNT HAS HAD 5 PT COMPLAINTS ABOUT AIR IN LINE ALARMS. NO SAMPLES ARE AVAILABLE. NO LOT NUMBER INFO WAS GIVEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CURLIN ADMINISTRATION SET FRN MOOG MEDICAL DEVICES GROUP 340-4114

    Patients

    Seq Age Sex Outcome Treatment
    1 CURLIN INFUSION PUMP