FDA Adverse Event Malfunction Summary report: N

ALARIS

MDR report key: 5999365 · Received October 5, 2016

Report

Report Number
5999365
Event Type
Malfunction
Date Received
October 5, 2016
Date of Event
June 16, 2016
Report Date
September 13, 2016
Manufacturer
CAREFUSION 303, INC.
Product Code
FRN
Product Problem
Yes
Report Source
User Facility report
Reporter Location
CA, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

THIS REPORT IS REPRESENTATIVE AS ONE OF 230 REPAIRS MADE BY THE BIOMEDICAL DEPARTMENT, OVER THE PAST 7 MONTHS, RELATED TO CRACKED AND BROKEN BEZELS AND/OR DOORS ON THE CARE FUSION ALARIS IV PUMP. IF THE DAMAGED DOOR IS NOT DETECTED BEFORE IT ENTIRELY DISINTEGRATES OR FALLS OFF, THE PUMP WILL POTENTIALLY DELIVER FREE FLOW MEDICATIONS LEADING TO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
650661 ALARIS PUMP, INFUSION FRN CAREFUSION 303, INC.

Patients

Seq Age Sex Outcome Treatment
1 NO