BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ECLIPSE HOMEPUMP

    MDR report key: 7472299 · Received April 27, 2018

    Report

    Report Number
    MW5076858
    Event Type
    Malfunction
    Date Received
    April 27, 2018
    Date of Event
    April 20, 2018
    Report Date
    April 25, 2018
    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# E101000, LOT # 0202811985) CONTAINING VANCOMYCIN 500 MG IN 0.9% SODIUM CHLORIDE 100 ML TUBING SNAPPED OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    313831 ECLIPSE HOMEPUMP ECLIPSE HOMEPUMP MEB HALYARD E101000 0202811985

    Patients

    Seq Age Sex Outcome Treatment
    1