FDA Adverse Event Malfunction Summary report: N

ALARIS SYSTEM

MDR report key: 24312566 · Received February 11, 2026

Report

Report Number
2016493-2026-05747
Event Type
Malfunction
Date Received
February 11, 2026
Date of Event
January 21, 2026
Report Date
April 6, 2026
Manufacturer
CAREFUSION SD
Product Code
FRN
UDI-DI
10885403810015
PMA / PMN Number
K133532
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A DEVICE HISTORY RECORD, COMPLAINT HISTORY REVIEW, AND RISK REVIEW ON FAILURE MODES ARE PERFORMED ON EACH DEVICE WITH REPORTABLE MALFUNCTION(S) ALONG WITH OTHER METHODS OF INVESTIGATION AS CODED IN SECTION H6 OF THIS MDR REPORT. THIS REPORT LISTS IMDRF ANNEX A, C, D, AND G CODES THAT ARE REPORTABLE MALFUNCTIONS OBSERVED ON THE DEVICE DURING SERVICING PER 803.52(F)(11)(III) THE INFORMATION PROVIDED WAS OBTAINED FROM SERVICING ACTIVITIES PERFORMED ON THE DEVICE. THERE WERE NO ADDITIONAL DETAILS OBTAINABLE OR PROVIDED AT THE TIME OF SERVICE.

Additional Manufacturer Narrative · 0

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 WAS OBTAINED FROM SERVICING ACTIVITIES PERFORMED ON THE DEVICE. THERE WERE NO ADDITIONAL DETAILS OBTAINABLE OR PROVIDED AT THE TIME OF SERVICE.

Additional Manufacturer Narrative · 0

A DEVICE HISTORY RECORD, COMPLAINT HISTORY REVIEW, AND RISK REVIEW ON FAILURE MODES ARE PERFORMED ON EACH DEVICE WITH REPORTABLE MALFUNCTION(S) ALONG WITH OTHER METHODS OF INVESTIGATION AS CODED IN SECTION H6 OF THIS MDR REPORT. THIS REPORT LISTS IMDRF ANNEX A, C, D, AND G CODES THAT ARE REPORTABLE MALFUNCTIONS OBSERVED ON THE DEVICE DURING SERVICING. PER 803.52(F)(11)(III) THE INFORMATION PROVIDED WAS OBTAINED FROM SERVICING ACTIVITIES PERFORMED ON THE DEVICE. THERE WERE NO ADDITIONAL DETAILS OBTAINABLE OR PROVIDED AT THE TIME OF SERVICE.

Description of Event or Problem · 0

IT WAS REPORTED THAT A FAILURE WAS OBSERVED DURING A PLANNED PREVENTATIVE MAINTENANCE, RECALL REMEDIATION, OR REPAIR ORDER SERVICE EVENT. [DEPOT REPAIR];[ERROR 232-6040, 232-RATE DISPLAY SAFETY SYSTEM, 6040 DISPLAY FAILURE]. THERE WAS NO REPORTED PATIENT INVOLVEMENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A FAILURE WAS OBSERVED DURING A PLANNED PREVENTATIVE MAINTENANCE, RECALL REMEDIATION, OR REPAIR ORDER SERVICE EVENT. [[SERVICE TYPE]];[ERROR 232-6040, 232-RATE DISPLAY SAFETY SYSTEM, 6040 DISPLAY FAILURE]. THERE WAS NO REPORTED PATIENT INVOLVEMENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A FAILURE WAS OBSERVED DURING A PLANNED PREVENTATIVE MAINTENANCE, RECALL REMEDIATION, OR REPAIR ORDER SERVICE EVENT. [[SERVICE TYPE]]; [ERROR 232-6040, 232-RATE DISPLAY SAFETY SYSTEM, 6040 DISPLAY FAILURE]. THERE WAS NO REPORTED PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
378631 ALARIS SYSTEM PUMP, INFUSION FRN CAREFUSION SD 8100 10885403810015

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown