Brand Name | EASYPUMP® II |
Type of Device | ELASTOMERIC INFUSION PUMP |
Manufacturer (Section D) |
B. BRAUN MELSUNGEN AG |
carl-braun-str. 1 |
melsungen, hessen 34212 |
GM 34212 |
|
Manufacturer (Section G) |
B. BRAUN MELSUNGEN AG |
carl-braun-str. 1 |
|
melsungen, 34212 |
GM
34212
|
|
Manufacturer Contact |
ludwig
schuetz
|
carl-braun-str. 1 |
melsungen, hessen 34212
|
GM
34212
|
5661712769
|
|
MDR Report Key | 4928842 |
MDR Text Key | 6433947 |
Report Number | 9610825-2015-00244 |
Device Sequence Number | 1 |
Product Code |
MEB
|
Combination Product (y/n) | N |
Reporter Country Code | FR |
PMA/PMN Number | K081905 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Health Professional,User Facility,Company Representative,company representati |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
10/21/2015,06/24/2015 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Expiration Date | 11/01/2019 |
Device Model Number | N/A |
Device Catalogue Number | 4540010 |
Device Lot Number | 14N18GE231 |
Other Device ID Number | N/A |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
Yes
|
Date Report Sent to FDA | 10/21/2015 |
Distributor Facility Aware Date | 06/24/2015 |
Device Age | 7 MO |
Event Location |
Hospital
|
Date Report to Manufacturer | 10/21/2015 |
Initial Date Manufacturer Received |
06/24/2015
|
Initial Date FDA Received | 07/21/2015 |
Supplement Dates Manufacturer Received | Not provided
|
Supplement Dates FDA Received | 10/21/2015
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 12/18/2014 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
|
|