BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALARIS

    MDR report key: 6145014 · Received December 5, 2016

    Report

    Report Number
    6145014
    Event Type
    Malfunction
    Date Received
    December 5, 2016
    Date of Event
    November 7, 2016
    Report Date
    November 9, 2016
    Manufacturer
    CAREFUSION 303, INC.
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT GETTING IV FLUID VIA PIGGYBACK AND AIR WAS IN THE IV TUBING. NO FLUID WAS INFUSING. ALARM DID NOT GO OFF. THE PUMP WAS SENT TO CLINICAL ENGINEERING AND IV TUBING AS WELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    795173 ALARIS PUMP, INFUSION FRN CAREFUSION 303, INC. 8015

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR