BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PAINSMART IOD

    MDR report key: 3190898 · Received June 14, 2013

    Report

    Report Number
    1722139-2013-01910
    Event Type
    Malfunction
    Date Received
    June 14, 2013
    Date of Event
    August 19, 2011
    Report Date
    November 1, 2011
    Manufacturer
    MOOG DEVICE GROUP
    Product Code
    FRN
    PMA / PMN Number
    K981816
    Removal / Correction Number
    Z-1870-2011
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    NEW PUMP SOFTWARE WAS INSTALLED. REF RECALL NUMBER Z-1870-2011.

    Description of Event or Problem · 1

    INFO RECEIVED STATES THAT PUMP HAD EXPERIENCED ERROR CODE 36.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271846 PAINSMART IOD FRN MOOG DEVICE GROUP PAINSMART IOD

    Patients

    Seq Age Sex Outcome Treatment
    1