BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FREEDOM 60 SET TUBING

    MDR report key: 245969 · Received October 25, 1999

    Report

    Report Number
    MW1017390
    Event Type
    Malfunction
    Date Received
    October 25, 1999
    Date of Event
    October 10, 1999
    Report Date
    October 12, 1999
    Manufacturer
    REPRO-MED SYSTEMS, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    UNABLE TO PRIME TUBING WITH MEDICATION SYRINGE. WHEN ATTEMPT MADE TO FORCE FLUID (MED) THROUGH TUBING THE FORCE CAUSED THE "WRAGS" OF THE MEDICATION SYRINGE RENDERING IT USELESS TO FREEDOM 60 PUMP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FREEDOM 60 SET TUBING FREEDOM 60 TUBING FPA REPRO-MED SYSTEMS, INC. PART# F60ML H225802

    Patients

    Seq Age Sex Outcome Treatment
    1 20 MO