FDA Adverse Event Malfunction Summary report: N

RENASYS GO PUMP SALE

MDR report key: 5148158 · Received October 14, 2015

Report

Report Number
3006760724-2015-00095
Event Type
Malfunction
Date Received
October 14, 2015
Date of Event
October 8, 2015
Report Date
October 9, 2015
Manufacturer
SMITH & NEPHEW, INC.
Product Code
OMP
PMA / PMN Number
K083375
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SMITH & NEPHEW, INC. IS SUBMITTING THE ABOVE REPORT TO COMPLY WITH 21 CFR PART 803, THE MEDICAL DEVICE REPORTING REGULATION. THE REPORT IS BASED UPON INFORMATION OBTAINED BY SMITH & NEPHEW, INC., WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY FDA.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE FAILED TO SOUND THE ALARM DESPITE THE AIR LEAKAGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
680599 RENASYS GO PUMP SALE NEGATIVE PRESSURE WOUND THERAPY POWERED SUCTION PUMP OMP SMITH & NEPHEW, INC.

Patients

Seq Age Sex Outcome Treatment
1