inforMED
MalfunctionMRZ

CADD PUMP COMMUNICATION MODULE

Received Sep 17, 2024 · Event occurred Aug 1, 2024

Report 3012307300-2024-09372 · MDR key 20240224

Device

Generic name

Accessories, Pump, Infusion

Catalog number

21-2131-01

Lot number

15863832

Product problems

  • Failure to Infuse
  • Failure to Infuse

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

NO PRODUCT WAS RETURNED. WE ARE UNABLE TO CONFIRM THE REPORTED COMPLAINT. IF THE PRODUCT IS RETURNED, THE MANUFACTURER WILL REOPEN THIS COMPLAINT FOR FURTHER INVESTIGATION. THE ROOT CAUSE WAS UNABLE TO BE ESTABLISHED. THE SERVICE HISTORY REVIEW HAD NO INDICATION THAT THE COMPLAINT WAS RELATED TO A SERVICE OF THE DEVICE WITHIN THE REVIEW PERIOD.

Additional Manufacturer Narrative

INVESTIGATION INCLUDING ROOT CAUSE ANALYSIS IS IN PROGRESS. A SUPPLEMENTAL MDR WILL BE FILED AS NECESSARY IN ACCORDANCE WITH 21 CFR 803.56 WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem

IT WAS REPORTED THAT THE DEVICE ALARM STATES UNUSABLE BATTERY, PUMP WOULD NOT RUN. PER REPORTER, THE ISSUE OCCURRED PRIOR TO INFUSION. THERE WAS NO PATIENT INVOLVEMENT.