FDA Adverse Event Malfunction Summary report: N

PLUM A+ UK WITH 3PIN

MDR report key: 3061449 · Received April 10, 2013

Report

Report Number
9615050-2013-00679
Event Type
Malfunction
Date Received
April 10, 2013
Date of Event
March 1, 2013
Report Date
March 12, 2013
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K070398
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING TESTING AT THE USER FACILITY, IT WAS NOTED THAT THE DEVICE DISTAL PRESSURE SENSOR PIN WAS BROKEN. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS AND NO REPORTED DELAYS OF CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. THOUGH REQUESTED, NO ADDITIONAL INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
153403 PLUM A+ UK WITH 3PIN 80 FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA PLUM A+ SOFTWARE MODULE: LIST #12097, SN (B)(4)