BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ECLIPSE HOMEPUMP

    MDR report key: 6673131 · Received June 26, 2017

    Report

    Report Number
    MW5070675
    Event Type
    Malfunction
    Date Received
    June 26, 2017
    Date of Event
    June 26, 2017
    Report Date
    June 26, 2017
    Manufacturer
    HALYARD
    Product Code
    MEB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    UPON FILLING ECLIPSE HOMEPUMP (MODEL #E252500, LOT # 0008032539) WITH 0.9 PERCENT SODIUM CHLORIDE 120 ML, TECHNICIAN WAS UNABLE TO CLAMP TUBING AS IT IS THREADED INCORRECTLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    447413 ECLIPSE HOMEPUMP ECLIPSE HOMEPUMP MEB HALYARD E252500 0008032539

    Patients

    Seq Age Sex Outcome Treatment
    1