BEUDAMED
    FDA Adverse Event Other Summary report: N

    CLAVE HORIZON PUP IV SET

    MDR report key: 529097 · Received May 14, 2004

    Report

    Report Number
    529097
    Event Type
    Other
    Date Received
    May 14, 2004
    Date of Event
    April 1, 2004
    Report Date
    April 1, 2004
    Manufacturer
    B BRAUN MEDICAL, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    A NEW IV (INTRAVENOUS) BAG AND IV TUBING WERE HUNG. IV PUMP ALARMED: SYSTEM ERROR. NEW IV TUBING (NEW LOT NUMBER) HUNG AND IV PUMP STARTED. IV RAN WITH NO PROBLEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CLAVE HORIZON PUP IV SET IV TUBING FPA B BRAUN MEDICAL, INC. CC3130 5082-1

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR