FDA Adverse Event Malfunction Summary report: N

EASYPUMP

MDR report key: 7868263 · Received September 12, 2018

Report

Report Number
9610825-2018-00186
Event Type
Malfunction
Date Received
September 12, 2018
Report Date
October 31, 2018
Manufacturer
B. BRAUN MELSUNGEN AG
Product Code
MEB
UDI-DI
04046964448638
PMA / PMN Number
K081905
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

EXEMPTION NUMBER E2016018 B. BRAUN INC. (BBMI) (IMPORTER) IS SUBMITTING THE REPORT ON BEHALF OF B. BRAUN MELSUNGEN AG (MANUFACTURER). THIS REPORT HAS BEEN IDENTIFIED AS EVENT ONE OF B. BRAUN MEDICAL INC. INTERNAL REPORT NUMBER(B)(4). THE INVESTIGATION INTO THIS REPORTED EVENT IS ONGOING. ADDITIONAL ATTEMPTS TO RECEIVE SAMPLES ARE BEING MADE. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN THE RESULTS OF THE INVESTIGATION ARE AVAILABLE.

Additional Manufacturer Narrative · 0

EXEMPTION NUMBER E2016018. B. BRAUN INC. (BBMI) (IMPORTER) IS SUBMITTING THE REPORT ON BEHALF OF B. BRAUN MELSUNGEN AG (MANUFACTURER). THIS REPORT HAS BEEN IDENTIFIED AS EVENT ONE OF B. BRAUN MEDICAL INC. INTERNAL REPORT NUMBER (B)(4). THE ACTUAL DEVICE INVOLVED IN THE REPORTED INCIDENT WAS NOT RETURNED FOR EVALUATION. WITHOUT THE ACTUAL SAMPLE OR A REPORTED BATCH A THOROUGH ROOT CAUSE ANALYSIS COULD NOT BE PERFORMED AND NO SPECIFIC CONCLUSIONS CAN BE DRAWN. ALTHOUGH SAMPLES WEREN'T RECEIVED, THE IFU FOR THE PRODUCT DOES SPEAK TO SOME POSSIBILITIES THAT COULD CAUSE THE PUMP TO EMPTY FASTER THAN THE NOMINAL TIME: POSSIBILITY 1: THE TEMPERATURE OF THE SURROUNDING WILL AFFECT THE FLOW RATE OF THE PUMP. FOR EVERY INCREASE OF 1°C, THE FLOW RATE OF THE PUMP WILL INCREASE BY APPROXIMATELY 3%. FOR EXAMPLE, IF THE FLOW RESTRICTOR OF THE PRODUCT REACHES THE TEMPERATURE OF 37°C, THE FLOW RATE OF THE PUMP WILL INCREASE BY APPROXIMATELY 18%, WHICH MEANS THAT THE FLOW RATE WOULD INCREASE FROM 5ML/HR TO APPROXIMATELY 6ML/HR. POSSIBILITY 2: EXTERNAL PRESSURE SUCH AS SQUEEZING OR LAYING ON THE PUMP WILL INCREASE THE FLOW RATE. IF ADDITIONAL PERTINENT INFORMATION BECOMES AVAILABLE A FOLLOW-UP REPORT WILL BE FILED.

Description of Event or Problem · 0

AS REPORTED BY USER FACILITY: EVENT 1: EASYPUMP 5 ML/HR - 270 ML FILLED WITH NS AND 5FU TO 230/240 ML RAN OVER 24 HRS INSTEAD OF 46 HRS. FLOW RESTRICTOR WAS TAPED TO THE PATIENT'S SKIN. THE PATIENT WAS VERY ACTIVE AND THE REGION WAS EXPERIENCING A HEAT WAVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
709787 EASYPUMP PUMP, INFUSION, ELASTOMERIC MEB B. BRAUN MELSUNGEN AG UNKNOWN 04046964448638

Patients

Seq Age Sex Outcome Treatment
1