FDA Adverse Event Death Summary report: N

GEMINI

MDR report key: 6156 · Received July 16, 1993

Report

Report Number
34544-1993-00001
Event Type
Death
Date Received
July 16, 1993
Date of Event
November 23, 1992
Report Date
June 7, 1993
Manufacturer
IMED
Product Code
FRN
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
PA, US
Reporter Occupation
UNKNOWN

Narratives

Description of Event or Problem · 1

ON NOVEMBER 23, 1992 THE PATIENT WAS RECEIVING A MORPHINE DRIP ORDERED TO INFUSE AT THE RATE OF 1MG PER HOUR. AT APPROX. 1230 P.M. IT WAS DISCOVERED THAT THE PATIENT RECEIVED A TOTAL OF 100 MG OF MORPHINE OVER A PERIOD OF FOUR (4) HOURS.THE PATIENT WAS PRONOUNCE DEAD ON NOVEMBER 24, 1992 AT 4:00 A.M. THE PATIENT'S DEATH CERTIFICATE IDENTIFIES THE CAUSE OF DEATH AS RESPIRATORY FAILURE. THE IMED GEMINI PC-2 IV PUMP WAS IMMEDIATELY TAKEN OUT OF SERVICE . AN INDEPENDENT EVALUATION OF THE IV PUMP WAS SCHEDULED AND PERFORMED. THE FINDINGS INDICATE THAT THE IV PUMP MALFUNCTIONEDDEVICE NOT LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: CRITICAL CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.DEVICE SERVICED IN ACCORDANCE WITH SERVICE SCHEDULE. DATE LAST SERVICED: 01-OCT-92. SERVICE PROVIDED BY: USER FACILITY BIOMEDICAL/BIOENGINEERING DEPARTMENT. SERVICE RECORDS AVAILABLE.NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, MECHANICAL TESTS PERFORMED, PERFORMANCE TESTS PERFORMED, VISUAL EXAMINATION. RESULTS OF EVALUATION: COMPONENT FAILURE, MECHANICAL PROBLEM, COMPONENT FAILURE, VALVE. CONCLUSION: DEVICE FAILURE DIRECTLY CAUSED EVENT, DEVICE WAS OUT OF CALIBRATION, DEVICE WAS OUT OF SPEC IN A MANNER THAT RELATES TO EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: DEVICE TEMPORARILY REMOVED FROM SERVICE, OTHER. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GEMINI I.V. INFUSION PUMP FRN IMED PC-2 N/A

Patients

Seq Age Sex Outcome Treatment
1 64 YR Death