MAUDE Adverse Event Report: COVIDIEN KANGAROO JOEY; PUMP, INFUSION, ENTERAL

Device Problems Fire (1245); Improper or Incorrect Procedure or Method (2017); Electrical Shorting (2926)

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

Event Date 05/29/2019

Event Type  malfunction  

Event Description

The patient was on multiple iv infusions and a tube feeding, which was being delivered via pump.Clear iv fluid dripped on to the tube feeding power supply where the pump plugs in and started a fire.The fluids dripping on the electrical connection of the feeding pump electrical connector shorted out the connecter, causing it to burst into flames.Equipment was evaluated by the biomed department.It is believed there was no issue with the pump, and the cause was "user error" in allowing fluid to drip onto the equipment.Pump has been returned to service.

• Brand Name: KANGAROO JOEY
• Type of Device: PUMP, INFUSION, ENTERAL
• Manufacturer (Section D): COVIDIEN; 2824 airwest boulevard; plainfield IN 46168
• MDR Report Key: 8832190
• MDR Text Key: 152371025
• Report Number: 8832190
• Device Sequence Number: 1
• Product Code: LZH
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: User Facility
• Reporter Occupation: Risk Manager
• Type of Report: Initial
• Report Date: 06/05/2019

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 07/26/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: No Information
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: Yes
• Date Report Sent to FDA: 06/05/2019
• Event Location: Hospital
• Date Report to Manufacturer: 07/26/2019
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: N
• Patient Sequence Number: 1