FDA Adverse Event Malfunction Summary report: N

ENTERALITE INFINITY ENTERAL FEEDING PUMP

MDR report key: 2961490 · Received January 17, 2013

Report

Report Number
1722139-2013-00102
Event Type
Malfunction
Date Received
January 17, 2013
Date of Event
December 19, 2012
Report Date
December 19, 2012
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
LZH
PMA / PMN Number
K031199
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION FOUND THAT PUMP WAS TESTED FOR ACCURACY SEVERAL TIMES, USING WATER. PUMP DELIVERED AMOUNT WITHIN SPEC (SPEC IS +/- 5%). COMPLAINT COULD NOT BE CONFIRMED.

Description of Event or Problem · 1

CUSTOMER STATES THAT PUMP DELIVERS 2/3 OF DOSE INSTEAD OF 3420 ML. RATE AND DOSE PROVIDED ARE 19 ML/HR AND 3420 ML.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
27110 ENTERALITE INFINITY ENTERAL FEEDING PUMP LZH MOOG MEDICAL DEVICES GROUP INFINITY PUMP

Patients

Seq Age Sex Outcome Treatment
1 22 YR PEPTEMIN