FDA Adverse Event
Malfunction
Summary report: N
EASYPUMP II LT 100-50-S
MDR report key: 3063536
·
Received April 12, 2013
Report
- Report Number
- 3009089744-2013-00081
- Event Type
- Malfunction
- Date Received
- April 12, 2013
- Date of Event
- March 4, 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
Narratives
Additional Manufacturer Narrative · 1
(B)(4). NO SAMPLE IS AVAILABLE FOR INVESTIGATION. WE HAVE INFORMED OUR PRODUCTION SITE ACCORDINGLY. A FOLLOW-UP REPORT WILL BE PROVIDED AFTER THE STATEMENT IS 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)): NO INFUSION OF CHEMOTHERAPY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 157642 | EASYPUMP II LT 100-50-S | ELASTOMERIC INFUSION PUMP | MEB | B. BRAUN MEDICAL PRODUCTION LTD. | NA | 2C1528EH11 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Other |