BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ECLIPSE HOMEPUMP

    MDR report key: 6800148 · Received August 15, 2017

    Report

    Report Number
    MW5071615
    Event Type
    Malfunction
    Date Received
    August 15, 2017
    Date of Event
    August 1, 2017
    Report Date
    August 15, 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

    ECLIPSE HOMEPUMP (MODEL E252500, LOT # 0202660992) FILLED WITH AZITHROMYCIN 500 MG/ 0.9 PERCENT SODIUM CHLORIDE 250 ML LEAKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    575002 ECLIPSE HOMEPUMP ECLIPSE HOMEPUMP MEB HALYARD E252500 0202660992

    Patients

    Seq Age Sex Outcome Treatment
    1