MAUDE Adverse Event Report: ZEVEX/MOOG ENTERALITE INFINITY; FEEDING PUMP

Device Problems Smoking (1585); Sparking (2595)

Patient Problem No Known Impact Or Consequence To Patient (2692)

Event Date 04/06/2015

Event Type  Injury  

Event Description

Rt in pt's room and noticed sparks and smoke coming from the electrical outlet.Feeding pump immediately unplugged and pt transferred.Bedside nurse, cnc, and clinical manager notified.Biomed, maintenance, eco, and house supervisor notified.

• Brand Name: ENTERALITE INFINITY
• Type of Device: FEEDING PUMP
• Manufacturer (Section D): ZEVEX/MOOG; salt lake city UT 84123
• MDR Report Key: 4802342
• MDR Text Key: 20017169
• Report Number: MW5042852
• 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: 05/21/2015

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/21/2015
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Is the Reporter a Health Professional?: No
• Patient Sequence Number: 1
• Patient Age: 14 YR
• Patient Weight: 46