| Brand Name | CADD-Legacy One Ambulatory Infusion Pump |
| Common Device Name | Pump, infusion |
| Manufacturer (Section D) |
| ICU Medical, Inc. |
| 6000 nathan lane north |
| minneapolis MN 55442 |
|
| Manufacturer Contact |
|
reed
covert
|
| 600 n. field dr. |
| lake forest, IL 60045
|
|
+1(224)706-2300
|
|
| MDR Report Key | 50209626 |
| Report Number | 3012307300-2026-07974 |
| Device Sequence Number | 6097944 |
| Product Code |
FRN
|
| UDI-Device Identifier | 10610586019548 |
| UDI-Public | (01)10610586019548(11)150215 |
| Combination Product (Y/N) | N |
| Initial Reporter State | KS |
| Initial Reporter Country | US |
| PMA/510(K) Number | K982838 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Distributor |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/30/2026 |
| 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 |
Lay User/Patient
|
| Device Model Number | 6400 |
| Device Catalogue Number | 21-6400-51 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/22/2026 |
| Supplement Date Received by Manufacturer | 09/10/2026
|
| Initial Report FDA Received Date | 08/11/2026 |
| Supplement Report FDA Received Date | 09/30/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/15/2015 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|