| Brand Name | Alaris System |
| Common Device Name | Pump, Infusion |
| Manufacturer (Section D) |
| CAREFUSION 303, INC. |
| 3750 torrey view ct |
| san diego CA 92130 |
|
| Manufacturer (Section G) |
| CareFusion 303, INC. |
| 10020 pacific mesa blvd |
|
| san diego CA 92121 -438 |
|
| Manufacturer Contact |
|
brett
wilko
|
| 3750 torrey view ct |
| san diego, CA 92130
|
|
+1(858)617-2000
|
|
| MDR Report Key | 50025330 |
| Report Number | 2016493-2026-48844 |
| Device Sequence Number | 21467774 |
| Product Code |
FRN
|
| UDI-Device Identifier | 10885403222054 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NY |
| Initial Reporter Country | US |
| PMA/510(K) Number | K051641 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Remedial Action |
Recall |
| Type of Report
| Initial |
| Report Date (Section B) |
07/22/2026 |
| 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 Number | 8100 |
| Device Catalogue Number | 8100 Alaris LVP Module |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 07/14/2026 |
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/21/2026 |
| Initial Report FDA Received Date | 07/27/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 11/07/2007 |
| 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
|
If action reported to FDA under 21 USC 360i(g), list FDA-assigned Recall Number or include a statement | Z-2718-2020 |
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|