FDA Adverse Event Injury Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 2479004 · Received February 22, 2012

Report

Report Number
1722139-2012-00142
Event Type
Injury
Date Received
February 22, 2012
Date of Event
January 10, 2012
Report Date
January 28, 2012
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
LZH
PMA / PMN Number
K031199
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE PUMP LOG SHOWS TWO OCCLUSIONS WITH ALARMS. THERE IS NO EVIDENCE FROM THE LOG THAT THE SET WAS REMOVED FROM THE PUMP TO CLEAR EITHER OCCLUSION BEFORE ANOTHER THERAPY WAS STARTED. FAILURE TO CLEAR THE OCCLUSION RESULTED IN THE PUMP INDICATING VOLUME WAS BEING DELIVERED WHEN IT DID NOT, DUE TO THE OCCLUSION.

Description of Event or Problem · 1

DISTRIBUTOR ALLEGED THEY RECEIVED A COMPLAINT THAT A CHILD WITH A MITOCHONDRIAL DISEASE WAS HOSPITALIZED FOR HYPOGLYCEMIA. THE PUMP HAD INDICATED A FEEDING OF 461ML BUT NOTHING WAS DELIVERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENTERALITE INFINITY ENTERAL FEEDING PUMP LZH MOOG MEDICAL DEVICES GROUP INFINITY PUMP

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization