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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 Computer Software Problem (1112)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/31/2026
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 issue where the device failed to communicate with the 8015 device was identified as logic board software incompatibility.Tech support recommended to flash 8120 to correct version 12.1.2.78.Issue was resolved according to biomed.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 will not communicate with an 8015 device.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 Key24935005
Report Number2016493-2026-22615
Device Sequence Number20125809
Product Code MEA
UDI-Device Identifier10885403812002
UDI-Public(01)10885403812002
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
K043299
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) 04/13/2026
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 03/31/2026
Initial Report FDA Received Date04/21/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/11/2019
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
Concomitant Medical Products
and Therapy/Usage Dates
8015
Patient SexUnknown
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