FDA Adverse Event Other Summary report: N

PYXIS ANESTHESIA SYSTEM (PAS)

MDR report key: 2849232 · Received November 21, 2012

Report

Report Number
2016493-2012-00005
Event Type
Other
Date Received
November 21, 2012
Date of Event
November 2, 2012
Report Date
November 2, 2012
Manufacturer
CAREFUSION
Product Code
BRY
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). ADDITIONAL DATA / FAILURE INVESTIGATION. CAUSE OF FAILURE IS DETERMINED TO BE CUSTOMER CAUSED. CUSTOMER SPILLED IV FLUIDS ONTO THE UPS POWER SUPPLY, WHICH INGRESSED INTO THE ELECTRICAL COMPONENTS.

Description of Event or Problem · 1

CUSTOMER REPORT OF SMOKE FROM THE UPS POWER SUPPLY ON THE PAS DEVICE. CUSTOMER DENIES OBSERVING ANY SPARK OR FLAME. PATIENT WAS PRESENT. THERE WAS NO HARM TO THE PATIENT OR ANY USER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PYXIS ANESTHESIA SYSTEM (PAS) AUTOMATED DISPENSING CABINET (ADC'S) BRY CAREFUSION 3500 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK