FDA Adverse Event Malfunction Summary report: N

AMBIT PUMP CASSETTE

MDR report key: 843294 · Received February 28, 2007

Report

Report Number
1722214-2007-00010
Event Type
Malfunction
Date Received
February 28, 2007
Report Date
February 17, 2006
Manufacturer
SORENSON MEDICAL, INC.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ON FEBRUARY 22, 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 THE PATIENT WAS ALERTED TO BLOOD THAT HAD BACKED UP THE TUBING AND LEAKED FROM THE PUMP. THE THERAPY WAS HYDRATION. 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 511029

Patients

Seq Age Sex Outcome Treatment
1 *