FDA Adverse Event Malfunction Summary report: N

EASYPUMP II LT 270-27-S

MDR report key: 3063454 · Received April 12, 2013

Report

Report Number
3009089744-2013-00079
Event Type
Malfunction
Date Received
April 12, 2013
Date of Event
March 25, 2013
Report Date
April 12, 2013
Manufacturer
B. BRAUN MEDICAL PRODUCTION LTD.
Product Code
MEB
PMA / PMN Number
K081905
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE IS CURRENTLY ON SHIPPING FROM (B)(6) TO B. BRAUN (B)(4) FOR INVESTIGATION. A FOLLOW-UP REPORT WILL BE PROVIDED AFTER THE INSPECTION RESULTS ARE AVAILABLE.

Description of Event or Problem · 1

AS REPORTED BY THE USER FACILITY (TRANSLATION OF USER FACILITY INFORMATION BY BBM SALES ORGANIZATION IN (B)(6)): FAST FLOW. DRUG: VANCOMYCIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
157425 EASYPUMP II LT 270-27-S ELASTOMERIC INFUSION PUMP MEB B. BRAUN MEDICAL PRODUCTION LTD. NA 2D1028ED12

Patients

Seq Age Sex Outcome Treatment
1 UNK Other