BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OUTLOOK

    MDR report key: 3032680 · Received March 28, 2013

    Report

    Report Number
    MW5029574
    Event Type
    Injury
    Date Received
    March 28, 2013
    Date of Event
    March 19, 2013
    Report Date
    March 28, 2013
    Manufacturer
    B. BRAUN
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IVS AND PAIN MEDICATION NEEDED AFTER SURGERY COULD NOT BE DELIVERED BECAUSE TWO (2) B BRAUN OUTLOOK 100 IV PUMPS WERE FREQUENTLY GOING INTO AN EMPTY BAG ALARM. THE PT WAS IN A LOT OF PAIN. TREATMENT WAS DELAYED. THE NURSE HAD TO FREQUENTLY HAVE TO RETURN TO RESTART THE IV PUMP. (B)(6).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    128349 OUTLOOK PUMP, IV, LARGEVOLUM FRN B. BRAUN OUTLOOK 100 NA
    128350 OUTLOOK 100 PUMP, IV, LARGEVOLUME FRN B. BRAUN OUTLOOK 100

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Life Threatening IV PUMP #2: B. BRAUN| OUTLOOK 100 IV PUMP, SERIAL NUMBER (B)(4)