FDA Adverse Event Malfunction Summary report: N

MRIDIUM MRI INFUSION PUMP

MDR report key: 2704165 · Received August 13, 2012

Report

Report Number
3005053560-2012-00004
Event Type
Malfunction
Date Received
August 13, 2012
Date of Event
July 10, 2012
Report Date
August 10, 2012
Manufacturer
IRADIMED CORPORATION
Product Code
FRN
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP HAS BEEN EXAMINED BY IRADIMED CORPORATION AND FOUND TO OPERATE WITHIN SPECIFICATION. THE INFUSION SET USED DURING THIS EVENT WAS DISCARDED BY THE HOSPITAL AND IS NOT AVAILABLE FOR INSPECTION. INVESTIGATION IS STILL IN PROCESS. A FOLLOW-UP REPORT WILL BE FILED WITHIN 30 DAYS OF THIS REPORT.

Description of Event or Problem · 1

DURING AN MRI INFUSION, A PT RECEIVED AN OVER-INFUSION OF PROPOFOL. THE HOSPITAL REPORTED THE PT RECEIVED APPROXIMATELY 40 ML IN A SHORT PERIOD OF TIME. NO PT INJURY OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MRIDIUM MRI INFUSION PUMP INFUSION PUMP FRN IRADIMED CORPORATION 3860

Patients

Seq Age Sex Outcome Treatment
1 6 YR Required Intervention