| Brand Name | REMUNITY PUMP FOR REMODULIN (TREPROSTINIL) INJECTION |
| Common Device Name | INFUSION PUMP |
| Manufacturer (Section D) |
| MILLYARD ADVANCED MEDICAL PRODUCTS, LLC |
| 540 n. commercial st. |
| suite 306 |
| manchester NH 03101 |
|
| Manufacturer (Section G) |
| MILLYARD ADVANCED MEDICAL PRODUCTS, LLC |
| 540 n. commercial st. |
| suite 306 |
| manchester NH 03101 |
|
| Manufacturer Contact |
|
victoria
maroon
|
| 540 n. commercial st. |
| suite 306 |
| manchester, NH 03101
|
|
6032060591
|
|
| MDR Report Key | 25850730 |
| Report Number | 3016798778-2026-00229 |
| Device Sequence Number | 5532753 |
| Product Code |
QJY
|
| UDI-Device Identifier | 00850017421035 |
| UDI-Public | (01)00850017421035 |
| Combination Product (Y/N) | N |
| Initial Reporter State | IL |
| Initial Reporter Country | US |
| PMA/510(K) Number | K202690 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Distributor |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
07/16/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Lay User/Patient
|
| Device Model Number | DKPI-11042-001 |
| 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 | 06/17/2026 |
| Initial Report FDA Received Date | 07/16/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| 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 |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Age | 52 YR |
| Patient Sex | Female |
| Patient Weight | 83 KG |