| 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 | 50515256 |
| Report Number | 2016493-2026-58690 |
| Device Sequence Number | 9375802 |
| Product Code |
FRN
|
| Combination Product (Y/N) | N |
| Initial Reporter Country | CA |
| PMA/510(K) Number | K133532 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional |
| Initial Reporter Occupation |
Pharmacist
|
| Type of Report
| Initial |
| Report Date (Section B) |
08/24/2026 |
| 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 |
Health Professional
|
| Device Model Number | 8015 |
| Device Catalogue Number | 8015 Alaris PCU 1.5 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 | 08/14/2026 |
| Initial Report FDA Received Date | 08/31/2026 |
| 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 |
Unknown
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|