FDA Adverse Event Death Summary report: N

MS16A SYRINGE DRIVER

MDR report key: 508302 · Received January 23, 2004

Report

Report Number
9612511-2004-00001
Event Type
Death
Date Received
January 23, 2004
Date of Event
April 10, 2002
Report Date
January 23, 2004
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

SYRINGE DRIVER COMMENCED INFUSION OF DIAMORPHINE 20MG., CYCLIZINE 150MG AND MEDAZOLAM 5 MG. AT 15.15. AT 19.15 DRIVER WAS FOUND TO BE RUNNING TOO FAST. 18MM HAD BEEN DISPENSED IN 4 HRS INSTEAD OF 2MM/HR. PUMP STOPPED. DR. INFORMED. PT CHECKED AND STABLE. EVEN THOUGH THERE WAS A PT DEATH CO DOES NOT HAVE ANY DETAILS. REP AT THE HOSP SAID THAT THE PT DEATH IS NOT ATTRIBUTED TO THE ALLEGED OVERINFUSION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MS16A SYRINGE DRIVER SYRINGE DRIVER FRN GRASEBY MEDICAL LTD. MS16A NA

Patients

Seq Age Sex Outcome Treatment
1 64 YR Death