BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EMERSON PUMP

    MDR report key: 79196 · Received March 21, 1997

    Report

    Report Number
    1216146-1997-00002
    Event Type
    Malfunction
    Date Received
    March 21, 1997
    Date of Event
    February 1, 1997
    Report Date
    February 27, 1997
    Manufacturer
    G.H. EMERSON CO.
    Product Code
    KDQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    UPON ASSESSING PT WITH PNEUMONIA, FOUND THE RIGHT CHEST TUBE SUCTION VIA PUMP NOT WORKING. PT CONDITION: DECREASED LOC, INCREASED RESPIRATORY RATE AND INCREASED EFFORT, UNEQUAL CHEST EXPANSION REQUIRING INSERTION OF A CHEST TUBE FOR COLLAPSED RIGHT LUNG. UPON INSPECTION OF MACHINE, FOUND BUSHINGS WORN OUT. THE MACHINE HAS NO ALARM TO SIGNAL WHEN UNIT QUITS WORKING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EMERSON PUMP POST OPERATIVE PUMP KDQ G.H. EMERSON CO. 55-JS *

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Hospitalization| L| R THORACIC CHEST TUBE ARGYLE SHERWOOD TUBING -CAT| DISPOSABLE DRAINAGE SET -EMERSON #550-3060| LOG #550-0160.