BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAXPLUS

    MDR report key: 3250774 · Received June 3, 2013

    Report

    Report Number
    3250774
    Event Type
    Malfunction
    Date Received
    June 3, 2013
    Date of Event
    May 13, 2013
    Report Date
    June 3, 2013
    Manufacturer
    CAREFUSION 303, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBING CONNECTOR BROKE AND COULD NOT BE CONNECTED.DEVICE #1IS THIS A LABORATORY DEVICE OR LABORATORY TEST?NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    245301 MAXPLUS SET, ADMINISTRATION, INTRAVASCULAR FPA CAREFUSION 303, INC. * 13038004

    Patients

    Seq Age Sex Outcome Treatment
    1 * OTHER