FDA Adverse Event
Malfunction
Summary report: N
CADD-LEGACY PUMP
MDR report key: 8161837
·
Received December 13, 2018
Report
- Report Number
- 3012307300-2018-08764
- Event Type
- Malfunction
- Date Received
- December 13, 2018
- Date of Event
- October 7, 2018
- Report Date
- December 13, 2018
- Manufacturer
- SMITHS MEDICAL ASD, INC.
- Product Code
- FRN
- PMA / PMN Number
- K982838
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
INFORMATION WAS RECEIVED THAT THE CADD LEGACY PUMP STARTED TO BEEP AND THEN STOPPED WORKING. PATIENT SWITCHED TO HER OTHER PUMP. DOES 45 NKM, FREQUENCY CONTINUOUS, ROUTE: INTRAVENOUSLY. DATES OF USE 2014 TO ONGOING. INFUSION IS LIFE SUSTAINING. NO REPORTED ADVERSE EFFECTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1000489 | CADD-LEGACY PUMP | PUMP, INFUSION | FRN | SMITHS MEDICAL ASD, INC. | 6400 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 59 YR |