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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITHS MEDICAL ASD, INC. CADD ADMINISTRATION SETS; SET, ADMINISTRATION, INTRAVASCULAR

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SMITHS MEDICAL ASD, INC. CADD ADMINISTRATION SETS; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Model Number 21-7346-24
Device Problems Volume Accuracy Problem (1675); Failure to Infuse (2340)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/13/2022
Event Type  malfunction  
Event Description
It was reported that a full bag of medication had not infused.Cadd pump indicated 106mls to be infused for another 5 hours according to settings.However, the bag remained full.Cadd pump switched (serial number (b)(4)) and same bag and tubing connected.Patient sent home and instructed to return next morning.Patient returned wednesday april 13 with bag still full of medication.Cadd pump indicated 108mls more to be infused for another 5 hours.A new epoch bag and tubing attached and same cadd pump used.Patient sent home and instructed to return to centre at 1600hrs.Patient returned and 120mls of drug infused.Same lot number for tubing both days.No patient injury was reported.Additional information from email: on (b)(6) 2022, the patient came back a little early as it didn?t look like the bag was emptying.And again we had an almost full 500 ml bag that should be almost empty but the pump looks like it counted down; patient reported no alarms going off and the pump whirred like it was working.It turns out that it is the same pump as the first patient we had problems with (that we went on to use the ?old? tubing with and it worked fine for the 4 remaining days.We are sending the pump to biomed to have the event log downloaded (for (b)(6) 2022 as well as 2 weeks ago).We have the lot number of the tubing and also reported that the tubing had no obvious kinks in it on inspection by pharmacy during preparation.(2 more incidents of drug volume not being infused via cadd solis vip pumps for a total of 5 incidents since march 29, 2022.4 different pumps used (1 of these is a loaner from smiths medical).Serial numbers: (b)(4), (loaner).See event notes for continuation.).
 
Manufacturer Narrative
No product or photographic evidence were provided to aid in this investigation.The complaint report offered insufficient details to determine whether this product functioned as intended, or was used in a manner consistent with its instructions for use (ifu) or failed to meet product specifications.Lacking any additional evidence, this complaint has been closed as unconfirmed.If the product is returned, smiths medical will reopen this complaint for further investigation.A manufacturing dhr review was not performed because the results of the complaint investigation do not indicate a problem with the manufacture of the device.
 
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Brand Name
CADD ADMINISTRATION SETS
Type of Device
SET, ADMINISTRATION, INTRAVASCULAR
Manufacturer (Section D)
SMITHS MEDICAL ASD, INC.
6000 nathan lane north
minneapolis MN 55442
Manufacturer (Section G)
SMITHS MEDICAL ASD, INC.
6000 nathan lane north
minneapolis MN 55442
Manufacturer Contact
jim vegel
6000 nathan lane north
minneapolis, MN 55442
MDR Report Key14366379
MDR Text Key291723200
Report Number3012307300-2022-08606
Device Sequence Number1
Product Code FPA
UDI-Device Identifier15019517161953
UDI-Public15019517161953
Combination Product (y/n)N
Reporter Country CodeCA
PMA/PMN Number
K031361
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility
Reporter Occupation Other
Type of Report Initial
Report Date 05/11/2022
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 Model Number21-7346-24
Device Catalogue Number21-7346-24
Device Lot Number4235006
Was Device Available for Evaluation? No
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 04/12/2022
Initial Date FDA Received05/11/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/17/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient SexMale
Patient Weight75 KG
Patient RaceWhite
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