MAUDE Adverse Event Report: COVIDIEN COVIDIEN; FEEDING PUMP

Device Problem Failure to Infuse (2340)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 12/12/2013

Event Type  malfunction  

Event Description

Nurse in the room working and noticed that pt's feeding pump was on but feeding was not infusing and there was no alarm going off.No harm to pt.Pump was removed and cleaned and labeled not working.

• Brand Name: COVIDIEN
• Type of Device: FEEDING PUMP
• Manufacturer (Section D): COVIDIEN; mansfield MA 02048
• MDR Report Key: 3557779
• MDR Text Key: 4050069
• Report Number: MW5033720
• Device Sequence Number: 1
• Product Code: LZH
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 12/31/2013

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 01/02/2014
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Is the Reporter a Health Professional?: Yes
• Patient Sequence Number: 1
• Patient Age: 81 YR