FDA Adverse Event Malfunction Summary report: N

TUMESCENT INFILTRATION PUMP

MDR report key: 3767956 · Received April 23, 2014

Report

Report Number
2953189-2014-00052
Event Type
Malfunction
Date Received
April 23, 2014
Date of Event
March 24, 2014
Report Date
March 24, 2014
Manufacturer
COVIDIEN SAN JOSE
Product Code
FRN
PMA / PMN Number
K071588
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Additional Manufacturer Narrative · 1

THIS MDR IS BEING SUBMITTED AS A PART OF A RETROSPECTIVE REVIEW / REMEDIATION EFFORT PERFORMED AT THE COVIDIEN (B)(4) LOCATION, FOLLOWING MEDTRONIC¿S ACQUISITION OF COVIDIEN.  A CAPA HAS BEEN OPENED TO MANAGE THE ACTIONS RELATED TO REMEDIATION OF COMPLAINT FILES AND ANY REQUIRED MDR REPORTING.

Description of Event or Problem · 1

THE DP 20 WAS RETURNED TO NOUVAG USA INC. EVALUATION DETERMINED THAT THE FOOT PEDAL WAS DEFECTIVE.

Description of Event or Problem · 1

CUSTOMER STATES THAT THE TUMESCENT INFILTRATION PUMP RUNS CONTINUOUSLY, AND WILL NOT STOP PUMPING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
246934 TUMESCENT INFILTRATION PUMP PUMP, INFUSION FRN COVIDIEN SAN JOSE TPMP-01

Patients

Seq Age Sex Outcome Treatment
1 Other