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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITHS MEDICAL ASD, INC. CADD-LEGACY PCA AMBULATORY INFUSION PUMP; PUMP, INFUSION, PCA
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SMITHS MEDICAL ASD, INC. CADD-LEGACY PCA AMBULATORY INFUSION PUMP; PUMP, INFUSION, PCA Back to Search Results
Model Number 6300
Device Problems Device Alarm System (1012); Defective Component (2292); Air/Gas in Device (4062)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/01/2024
Event Type  malfunction  
Event Description
It was reported that the device exhibited air in the line and the air sensor was defective.The event occurred during testing; there was no patient involvement and no patient harm.
 
Manufacturer Narrative
B3: event date unknown.One device was returned for evaluation.Visual inspection revealed no physical damage.Event history log review was not applicable.Functional testing could not replicate the reported issue; the pump was found to be operating properly and passed all tests.The root cause was unknown.No further action was taken.Service history review identified there was no indication that the complaint was related to a service of the device within the review period.
 
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Brand Name
CADD-LEGACY PCA AMBULATORY INFUSION PUMP
Type of Device
PUMP, INFUSION, PCA
Manufacturer (Section D)
SMITHS MEDICAL ASD, INC.
6000 nathan ln n
minneapolis MN 55442
Manufacturer Contact
reed covert
6000 nathan lane north
minneapolis, MN 55442
2247062300
MDR Report Key18996664
MDR Text Key338926033
Report Number3012307300-2024-01894
Device Sequence Number1
Product Code MEA
Combination Product (y/n)N
Reporter Country CodeNL
PMA/PMN Number
UNKNOWN
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,User Facility
Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date 03/28/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/28/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number6300
Device Catalogue Number21-6300-06
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/29/2024
Date Manufacturer Received02/29/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/17/2013
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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