FDA Adverse Event Malfunction Summary report: N

CADD® CADD-PRIZM® VIP AMBULATORY INFUSION PUMP

MDR report key: 7958017 · Received October 11, 2018

Report

Report Number
3012307300-2018-04125
Event Type
Malfunction
Date Received
October 11, 2018
Date of Event
August 2, 2018
Report Date
January 7, 2019
Manufacturer
SMITHS MEDICAL ASD, INC.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION RECEIVED THAT THIS EVENT OCCURRED DURING TESTING AND THERE WAS NO PATIENT INVOLVEMENT.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION RECEIVED THAT THIS EVENT OCCURRED DURING TESTING AND THERE WAS NO PATIENT INVOLVEMENT.

Additional Manufacturer Narrative · 1

ONE PUMP WAS RETURNED FOR ANALYSIS IN USED CONDITION. VISUAL INSPECTION OF THE PUMP SHOWED THAT THE PUMP HAD A CHIPPED AIR DETECTOR AND FLUID INGRESSION. THE DEVICE EVENT LOG HAD NO RELATED FINDINGS BUT DID HAVE HIGH PRESSURE ALARM MESSAGES RECORDED. FUNCTIONAL TESTING INCLUDED USE TESTING. THE PUMP WAS POWERED ON AND AN ERROR CODE WAS DISPLAYED. THE SOFTWARE APPLICATIONS WERE REINSTALLED. BASED ON THE EVIDENCE, THE COMPLAINT WAS CONFIRMED. THE ROOT CAUSE WAS UNABLE TO BE DETERMINED. THE PUMP BATTERY DOOR WAS REPLACED.

Description of Event or Problem · 1

INFORMATION WAS RECEIVED INDICATING THAT THIS AMBULATORY INFUSION PUMP EXHIBITED AN ERROR CODE. IT WAS NOT SPECIFIED WHETHER OR NOT THIS OCCURRED DURING INFUSION OR INTERRUPTED THERAPY. IT WAS ALSO NOTED THAT THERE WAS AN ISSUE WITH THE PUMP'S BATTERY DOOR. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
798432 CADD® CADD-PRIZM® VIP AMBULATORY INFUSION PUMP PUMP, INFUSION FRN SMITHS MEDICAL ASD, INC. 6101

Patients

Seq Age Sex Outcome Treatment
1