BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BLICKMAN BUILT

    MDR report key: 3251510 · Received May 2, 2013

    Report

    Report Number
    3251510
    Event Type
    Malfunction
    Date Received
    May 2, 2013
    Report Date
    March 4, 2013
    Manufacturer
    BLICKMAN INC
    Product Code
    FOX
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US

    Narratives

    Description of Event or Problem · 1

    THE IV POLE IS UNSTABLE DURING TRANSPORT. THE WEIGHT OF THE IV PUMP LENDS ITSELF TO CAUSING THE IV POLE TO TIP OVER.WHAT WAS THE ORIGINAL INTENDED PROCEDURE?TRANSPORT OF IV PUMP.DEVICE #1IS THIS A LABORATORY DEVICE OR LABORATORY TEST?NO.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    193641 BLICKMAN BUILT STAND, INFUSION FOX BLICKMAN INC * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * IV PUMP