FDA Adverse Event Summary report: N

CADD-SOLIS

MDR report key: 2222631 · Received August 9, 2011

Report

Report Number
2222631
Date Received
August 9, 2011
Date of Event
August 9, 2011
Report Date
August 9, 2011
Manufacturer
SMITHS MEDICAL
Product Code
MEA
Report Source
User Facility report
Reporter Location
RI, US

Narratives

Description of Event or Problem · 1

WENT INTO PATIENT'S ROOM AT CHANGE OF SHIFT. ONCE IN ROOM, PCA PUMP BEGAN ALARMING, SCREEN WAS RED WITH CODE #48622 VISIBLE ON SCREEN. UNABLE TO SILENCE THE ALARM OR RESET PUMP. PATIENT DISCONNECTED FROM THE INFUSION IMMEDIATELY AND A NEW PUMP REQUESTED. BATTERIES WERE REMOVED FROM THE PUMP IN AN EFFORT TO RESET/STOP THE ALARM FROM CONTINUING. ONCE BATTERIES REMOVED AND REPLACED, THE PCA PUMP WAS ABLE TO BE TURNED ON. WHEN PROMPTED, DURING PROGRAMMING, FOR THE 3 DIGIT PASS CODE (B)(4), THE PUMP RESPONDED WITH MESSAGE THAT IT WAS THE INCORRECT PASS CODE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CADD-SOLIS INFUSION PUMP MEA SMITHS MEDICAL * *

Patients

Seq Age Sex Outcome Treatment
1 19 YR