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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CAREFUSION SD ALARIS SYSTEM; PUMP, INFUSION

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CAREFUSION SD ALARIS SYSTEM; PUMP, INFUSION Back to Search Results
Model Number 8120
Medical Device Problem Code Failure to Read Input Signal (1581)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/13/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Bd technical support troubleshoot with customer over the phone.A device history record, complaint history review, and risk review on failure modes are performed on each device with reportable malfunction(s) along with other methods of investigation as coded in section h6 of this mdr report.Root cause: the probable cause of the reported device failing the plunger force accuracy test was determined to be a faulty force sensor assembly.Tech support advised biomed that the issue may be caused by a mechanical problem and recommended replacing the complete housing assembly.Biomed confirmed that all other sections passed except for the plunger sensor and stated they would proceed with replacing the force sensor plate assembly.Per 803.52(f)(11)(iii) the information provided represents all of the known information at this time.The complainant or reporter was unable or unwilling to provide any further patient, product, or procedural details to the manufacturer.
 
Event or Problem Description
It was reported that the device had failing plunger force accuracy.There was no patient involvement.
 
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Brand Name
ALARIS SYSTEM
Common Device Name
PUMP, INFUSION
Manufacturer (Section D)
CAREFUSION SD
10020 pacific mesa blvd
san diego CA 92121 4386
Manufacturer (Section G)
CAREFUSION SD
10020 pacific mesa blvd
san diego CA 92121 4386
Manufacturer Contact
brett wilko
10020 pacific mesa blvd
san diego, CA 92121-4386
8586172000
MDR Report Key24646741
Report Number2016493-2026-15229
Device Sequence Number15954616
Product Code MEA
UDI-Device Identifier10885403812033
UDI-Public(01)10885403812033
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K042399
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 03/16/2026
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
Operator of Device Other
Device Model Number8120
Device Catalogue Number8120 ALARIS PCA MODULE
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/13/2026
Initial Report FDA Received Date03/20/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/02/2018
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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