BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HOSPIRA PRIMARY PLUMSET

    MDR report key: 2932886 · Received January 22, 2013

    Report

    Report Number
    MW5028759
    Event Type
    Malfunction
    Date Received
    January 22, 2013
    Date of Event
    January 2, 2013
    Report Date
    January 22, 2013
    Manufacturer
    HOSPIRA, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    VA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    NURSE GOT PT UP TO BEDSIDE CHAIR, LOOKED DOWN AND NOTICED THAT IV TUBING WAS BROKEN/SPLIT IN HALF. TO NURSE'S AND PT'S KNOWLEDGE THERE WAS NO REASON FOR THE BREAKAGE, IT HAD NOT GOTTEN CAUGHT ON ANYTHING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    31644 HOSPIRA PRIMARY PLUMSET NONE FPA HOSPIRA, INC. UNK

    Patients

    Seq Age Sex Outcome Treatment
    1