MalfunctionIZQ
ULRICH POWER INJECTOR
Received May 29, 2020 · Event occurred May 25, 2020
Report MW5094761 · MDR key 10104976
Device
Generic name
Injector, Contrast Medium, Automatic
Manufacturer
Ulrich Medical Usa, Inc.Lot number
M0190501
Product problems
- Material Rupture
Patient
80 YR
- No Consequences Or Impact To Patient
- No Consequences Or Impact To Patient
Narrative
Description of Event or Problem
EMERGENCY ROOM CT ULRICH POWER INJECTOR 24HOUR INTERNAL PUMP TUBING RUPTURED/LEAKED, NO HARM TO PATIENT. FDA SAFETY REPORT ID #: (B)(4).