FDA Adverse Event Summary report: N

RELIANCE EPS

MDR report key: 2508272 · Received March 28, 2012

Report

Report Number
9680353-2012-00022
Date Received
March 28, 2012
Date of Event
February 28, 2012
Report Date
March 28, 2012
Manufacturer
STERIS CANADA CORPORATION
Product Code
NZA
PMA / PMN Number
K102244
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A STERIS TECHNICIAN INSPECTED THE UNIT AND FOUND THE HOSE CLAMP ON THE UNIT'S HOT WATER SUPPLY LINE HAD LOOSENED, CAUSING THE HOSE TO COME OFF THE FITTING AND WATER TO LEAK. THE TECHNICIAN REPLACED THE HOSE AND CLAMP, TIGHTENED ALL CONNECTIONS AND PLACED THE UNIT BACK INTO SERVICE. NO FURTHER ISSUES HAVE BEEN REPORTED WITH THIS EQUIPMENT.

Description of Event or Problem · 1

THE USER FACILITY REPORTED THAT THE HOSE ON THE WATER LINE OF THE RELIANCE ENDOSCOPE PROCESSING UNIT DISCONNECTED AND FLOODED THE DEPARTMENT. NO INJURIES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RELIANCE EPS WASHER/DISINFECTOR NZA STERIS CANADA CORPORATION

Patients

Seq Age Sex Outcome Treatment
1