BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CAREFUSION

    MDR report key: 2941313 · Received January 25, 2013

    Report

    Report Number
    MW5028792
    Event Type
    Malfunction
    Date Received
    January 25, 2013
    Date of Event
    January 20, 2013
    Report Date
    January 25, 2013
    Manufacturer
    CAREFUSION
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SECONDARY I.V. FLUID NOTICEABLY BY PASSED THE IN-LINE CHECK VALVE AND ENTERED THE DRIP CHAMBER AS WELL AS THE PRIMARY I.V. FLUID BAG.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    36260 CAREFUSION INFUSION SET FPA CAREFUSION 2420-0500 12115251

    Patients

    Seq Age Sex Outcome Treatment
    1