BEUDAMED
    FDA Adverse Event Death Summary report: N

    MS26 SYRINGE DRIVER

    MDR report key: 490982 · Received October 21, 2003

    Report

    Report Number
    9612511-2003-00004
    Event Type
    Death
    Date Received
    October 21, 2003
    Date of Event
    August 2, 2003
    Report Date
    October 21, 2003
    Manufacturer
    GRASEBY MEDICAL LTD.
    Product Code
    FRN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    INCIDENT REPORTED BY REP. OF HOSP. INFORMED IN 10/2003 BUT STILL TO BE CONFIRMED, PUMP DELIVERING DIAMORPHINE AT A RATE OF 52 - 20ML SYRINGE. UNKNOWN HOW MUCH DRUG WAS OVERINFUSED EXACTLY BUT CUSTOMER QUOTES NOT A GREAT AMOUNT. SPOUSE OF PT NOTICED IT HAD GONE THROUGH TOO QUICKLY. REPORT STATES THAT PT DIED OF NATURAL CAUSES NOT DUE TO THE ALLEGED OVERINFUSION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MS26 SYRINGE DRIVER SYRINGE DRIVER FRN GRASEBY MEDICAL LTD. MS26 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Death| O