BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    I-FLOW

    MDR report key: 2982701 · Received February 22, 2013

    Report

    Report Number
    MW5029154
    Event Type
    Malfunction
    Date Received
    February 22, 2013
    Date of Event
    February 20, 2013
    Report Date
    February 22, 2013
    Manufacturer
    BRAUN
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ME, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    PT CALLED THIS A.M TO REPORT SHE DID NOT BELIEVE HER INFUSION PUMP WAS WORKING. UPON ARRIVAL TO OFFICE, PUMP FIRM AND PHARMACY CONFIRMED THAT NO MEDICATION INFUSED. NEW SET UP OBTAINED FROM PHARMACY AND CONNECTED TO PT. PT TO CALL IF NOTES SAME ISSUE WITH THIS PUMP SET UP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    77841 I-FLOW HOME INFUSION PUMP FRN BRAUN C270050 0200641852

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR