FDA Adverse Event Malfunction Summary report: N

GEMSTAR PAIN MGE SNG

MDR report key: 3832704 · Received March 26, 2014

Report

Report Number
9615050-2014-02278
Event Type
Malfunction
Date Received
March 26, 2014
Date of Event
January 23, 2014
Report Date
February 6, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K060806
Removal / Correction Number
Z-1169-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DURING TESTING AT THE SERVICE CENTER, THE DEVICE WOULD NOT POWER ON DC POWER; HOWEVER, WAS ABLE TO BE POWERED ON USING AC POWER. DURING FURTHER TESTING CORROSION DUE TO LEAKAGE FROM THE DISPOSABLE BATTERIES WAS NOTED ON THE BATTERY CONTACT, BATTERY DOOR, BATTERY COMPARTMENT, AND PRINTED CIRCUIT BOARD. THIS DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE DEVICE WAS RETURNED TO THE SERVICE CENTER WITH A REPORT FROM THE CUSTOMER CONTACT THAT THE DEVICE WOULD NOT POWER ON USING DC POWER; HOWEVER, IT WOULD POWER ON USING THE POWER CORD. THIS IS NOT A REPORTABLE FUNCTION. DURING VERIFICATION TESTING AT THE SERVICE CENTER, LEAKAGE FROM THE DISPOSABLE BATTERIES WAS NOTED IN THE BATTERY COMPARTMENT OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
176345 GEMSTAR PAIN MGE SNG 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA