FDA Adverse Event Malfunction Summary report: N

CONTINUUM MR INFUSION SYSTEM STANDARD ADMINISTRATION KIT

MDR report key: 2517912 · Received April 2, 2012

Report

Report Number
2520313-2012-00012
Event Type
Malfunction
Date Received
April 2, 2012
Date of Event
November 17, 2011
Report Date
November 17, 2011
Manufacturer
MEDRAD
Product Code
FPA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MEDRAD QUALITY ASSURANCE PRODUCT ANALYSIS RECEIVED AND TESTED THE CONTINUUM PUMP TO DETERMINE THE ROOT CAUSE OF THE UNDER INFUSION ISSUE. THE SITE DID NOT REPORT A LOT NUMBER OF THE MEDRAD CONTINUUM MR INFUSION SYSTEM STANDARD ADMINISTRATION KIT (MIK 200A) THAT WAS INVOLVED WITH THIS INCIDENT. PRELIMINARY INVESTIGATION AND ANALYSIS APPEARS TO INDICATE THAT CERTAIN LOT NUMBERS OF THE MIK 200A EXHIBIT VARIATION IN SPECIFICATIONS THAT MAY IMPACT THE FUNCTIONALITY OF THE PUMP AND THEREFORE MAY BE CONTRIBUTING TO THE UNDER INFUSION OF MEDICATION REPORTED BY THIS SITE. THIS INVESTIGATION AND ANALYSIS IS CONTINUING.

Description of Event or Problem · 1

A MEDRAD REP REPORTED THE FOLLOWING INFO: WHILE USING THE MEDRAD CONTINUUM MR INFUSION PUMP (SERIAL NUMBER (B)(4)) AND THE MEDRAD CONTINUUM MR INFUSION SYSTEM STANDARD ADMINISTRATION KIT (MIK 200A), THE SITE REPORTED THAT THE PUMP WAS DELIVERING LESS THAN PRESCRIBED WHILE INFUSING ADENOSINE. THERE WAS NO INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTINUUM MR INFUSION SYSTEM STANDARD ADMINISTRATION KIT INTRAVASCULAR ADMINISTRATION SET FPA MEDRAD 3008301 UNK

Patients

Seq Age Sex Outcome Treatment
1 MEDRAD CONTINUUM MR INFUSION PUMP