FDA Adverse Event Other Summary report: N

OUTLOOK 200

MDR report key: 778151 · Received November 1, 2006

Report

Report Number
1641965-2006-00036
Event Type
Other
Date Received
November 1, 2006
Date of Event
October 3, 2006
Report Date
October 30, 2006
Manufacturer
B. BRAUN MEDICAL, INC.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

SEVERAL ATTEMPTS WERE MADE TO OBTAIN SUSPECT DEVICE FROM THE CUSTOMER WITHOUT SUCCESS. THE F/U REPORT WILL BE SUBMITTED ONCE EVAL IS DONE.

Description of Event or Problem · 1

THE DEVICE WAS SET TO DELIVER A SOLUTION OF AZTREONAM ANTIBIOTIC WITH A RATE OF 100CC/HR FOR 1 HR DELIVERY IN THE PIGGYBACK MODE. REPORTEDLY, THE BAG WAS EMPTIED IN 5-10 MINS. THE PT WAS NOT INJURED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 OUTLOOK 200 INFUSION PUMP FRN B. BRAUN MEDICAL, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 * Other