RESQPUMP 12-0823-000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2017-07-28 for RESQPUMP 12-0823-000 manufactured by .

Event Text Entries

[81311055] The pump came to acsi with the force gauge reading at 0 kg. Upon the first test compression, the gauge became stuck at @50 kg. Nothing external or internal indicated that there were any modifications for misuse of the device. The pushrod assembly was stuck in the transfer spring, up about 1/4". The purshrod loosened up after some manipulation. The components were reassembled and the force gauge returned to zero. The force gauge was verified on a scale and all within specification. The gauge returned to zero after each compression/decompression. It is believed that excess loctite was on the pushrod stem. When the pump was compressed the pushrod must have gotten stuck in the up position causing the gauge to read high and not return to zero.
Patient Sequence No: 1, Text Type: N, H10


[81311056] As reported, resqpump gauge does not work.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003477173-2017-00004
MDR Report Key6750161
Report SourceHEALTH PROFESSIONAL
Date Received2017-07-28
Date of Report2017-07-28
Date of Event2017-06-30
Date Mfgr Received2017-06-30
Date Added to Maude2017-07-28
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 ContactMS DIANE HOWELL
Manufacturer Street1905 COUNTY RD C WEST
Manufacturer CityROSEVILLE MN 55113
Manufacturer CountryUS
Manufacturer Postal55113
Manufacturer Phone6514035600
Manufacturer G1SCIENTIFIC MOLDING CORPORATION
Manufacturer Street330 SMC DRIVE
Manufacturer CitySOMERSET WI 54025
Manufacturer CountryUS
Manufacturer Postal Code54025
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameRESQPUMP
Generic NameRESQPUMP
Product CodePIZ
Date Received2017-07-28
Returned To Mfg2017-07-12
Model Number12-0823-000
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
Manufacturer Address1905 COUNTY RD C WEST ROSEVILLE MN 55113 US 55113


Patients

Patient NumberTreatmentOutcomeDate
10 2017-07-28

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