BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EMERSON POST-OPERATIVE PUMP

    MDR report key: 564568 · Received January 7, 2005

    Report

    Report Number
    564568
    Event Type
    Malfunction
    Date Received
    January 7, 2005
    Date of Event
    December 22, 2004
    Report Date
    January 7, 2005
    Manufacturer
    J. H. EMERSON CO.
    Product Code
    JOL
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TX, US

    Narratives

    Description of Event or Problem · 1

    PATIENT WAS ON 40 CM SUCTION AND THE PUMP SIMPLY SHUT OFF. THE TOP OF THE PUMP WAS HOT TO THE TOUCH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EMERSON POST-OPERATIVE PUMP SUCTION PUMP JOL J. H. EMERSON CO. 55JS *

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR