FDA Adverse Event Malfunction Summary report: N

LC PCA HOSPIRA MEDNE

MDR report key: 3821138 · Received April 16, 2014

Report

Report Number
9615050-2014-02744
Event Type
Malfunction
Date Received
April 16, 2014
Date of Event
June 1, 2013
Report Date
March 24, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
MEA
PMA / PMN Number
K042800
Removal / Correction Number
FA301-02
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THE DEVICE ALARMED FOR SERVICE ALARMED WITH AN E630 (SCREW ROTATION ERROR) ERROR CODE. THE DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE RPTR UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTIVE MAINTENANCE TESTING AT THE USER FACILITY, AN E630 (SCREW ROTATION ERROR) ERROR CODE WAS NOTED. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS OR DELAYS IN CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. NO ADD'L INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
232687 LC PCA HOSPIRA MEDNE 80MEA MEA HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA