FDA Adverse Event Malfunction Summary report: N

AMBIT PUMP CASSETTE

MDR report key: 843291 · Received February 28, 2007

Report

Report Number
1722214-2007-00011
Event Type
Malfunction
Date Received
February 28, 2007
Report Date
September 5, 2006
Manufacturer
SORENSON MEDICAL, INC.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ON FEBRUARY 23, 2007, A RETROSPECTIVE AUDIT OF COMPLAINT FILES WAS CONDUCTED FOR COMPLAINTS ASSOCIATED WITH LEAKING CASSETTES, WHERE THE DEVICE WAS BEING USED FOR THE ADMINISTRATION OF NON-CHEMOTHERAPY DRUGS.

Description of Event or Problem · 1

THE DISTRIBUTOR REPORTED A LEAKING CASSETTE. THE THERAPY WAS PAIN MANAGEMENT. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENT ASSOCIATED WITH THIS MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AMBIT PUMP CASSETTE AMBULATORY INFUSION PUMP CASSETTE FRN SORENSON MEDICAL, INC. NA 605025

Patients

Seq Age Sex Outcome Treatment
1 *