BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ENTERALITE INFINITY ENTERAL FEEDING PUMP

    MDR report key: 2823601 · Received October 9, 2012

    Report

    Report Number
    1722139-2012-01007
    Event Type
    Malfunction
    Date Received
    October 9, 2012
    Date of Event
    September 9, 2012
    Report Date
    September 10, 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

    DEVICE WAS NOT RETURNED. A FOLLOW UP WILL BE SENT IF NEW INFORMATION IS RECEIVED.

    Description of Event or Problem · 1

    INFORMATION RECEIVED INDICATE FROM THE (B)(6) CALL. CALLER STATES THAT THE PUMP IS NOT DELIVERING ANY FOOD.

    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 53 YR