FDA Adverse Event Malfunction Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 2841833 · Received October 22, 2012

Report

Report Number
1722139-2012-01034
Event Type
Malfunction
Date Received
October 22, 2012
Date of Event
September 23, 2012
Report Date
September 24, 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. SEVERAL ATTEMPTS WERE MADE, BUT RECEIVED NO RESPONSE FROM CUSTOMER. PUMP SERIAL NUMBER WAS NOT PROVIDED, THEREFORE, A DHR REVIEW COULD NOT BE PERFORMED.

Description of Event or Problem · 1

INFORMATION RECEIVED INDICATES THAT PUMP ALARMS 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