CADD SOLIS HPCA PUMP 2110 21-2112-0100-51

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,user facility report with the FDA on 2019-10-30 for CADD SOLIS HPCA PUMP 2110 21-2112-0100-51 manufactured by Smiths Medical Asd, Inc..

Event Text Entries

[164339628] Information was received indicating that a smiths medical cadd solis pump kept infusing when trying to stop. There were no reported adverse events.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012307300-2019-05748
MDR Report Key9257063
Report SourceCONSUMER,USER FACILITY
Date Received2019-10-30
Date of Report2019-11-26
Date Mfgr Received2019-10-29
Device Manufacturer Date2012-12-28
Date Added to Maude2019-10-30
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactDAVE HALVERSON
Manufacturer Street6000 NATHAN LANE NORTH
Manufacturer CityMINNEAPOLIS MN 55442
Manufacturer CountryUS
Manufacturer Postal55442
Manufacturer Phone7633833310
Manufacturer G1SMITHS MEDICAL ASD, INC.
Manufacturer Street6000 NATHAN LANE NORTH
Manufacturer CityMINNEAPOLIS MN 55442
Manufacturer CountryUS
Manufacturer Postal Code55442
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCADD SOLIS HPCA PUMP
Generic NamePUMP, INFUSION, PCA
Product CodeMEA
Date Received2019-10-30
Returned To Mfg2019-10-07
Model Number2110
Catalog Number21-2112-0100-51
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSMITHS MEDICAL ASD, INC.
Manufacturer Address6000 NATHAN LANE NORTH MINNEAPOLIS MN 55442 US 55442


Patients

Patient NumberTreatmentOutcomeDate
10 2019-10-30

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