FDA Adverse Event Malfunction Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 2822071 · Received October 9, 2012

Report

Report Number
1722139-2012-00995
Event Type
Malfunction
Date Received
October 9, 2012
Date of Event
August 13, 2012
Report Date
August 14, 2012
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
LZH
PMA / PMN Number
K031199
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS NOT RETURNED.

Description of Event or Problem · 1

INFORMATION RECEIVED INDICATES THAT PUMP HAD EXPERIENCED ERROR CODE 13.

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