PUMP A127 GOFLO 72204968

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-24 for PUMP A127 GOFLO 72204968 manufactured by Smith & Nephew, Inc..

Event Text Entries

[112312758] (b)(6)
Patient Sequence No: 1, Text Type: N, H10


[112312759] It was reported that a calibration issue have caused high flow. The procedure was completed without any further problems with a backup device and theres was no delay reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003604053-2018-00104
MDR Report Key7632625
Date Received2018-06-24
Date of Report2018-08-05
Date of Event2018-06-06
Date Mfgr Received2018-08-02
Date Added to Maude2018-06-24
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJIM GONZALES
Manufacturer Street7000 WEST WILLIAM CANNON DR.
Manufacturer CityAUSTIN TX 78735
Manufacturer CountryUS
Manufacturer Postal78735
Manufacturer G1SMITH & NEPHEW, INC.
Manufacturer Street150 MINUTEMAN ROAD
Manufacturer CityANDOVER MA 01810
Manufacturer CountryUS
Manufacturer Postal Code01810
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePUMP A127 GOFLO
Generic NamePUMP, AIR, NON-MANUAL, FOR ENDOSCOPE
Product CodeFEQ
Date Received2018-06-24
Catalog Number72204968
Lot Number1709CE0033
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerSMITH & NEPHEW, INC.
Manufacturer Address150 MINUTEMAN ROAD ANDOVER MA 01810 US 01810


Patients

Patient NumberTreatmentOutcomeDate
10 2018-06-24

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