FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1023092 · Received April 3, 2008

Report

Report Number
6000001-2007-00331
Event Type
Malfunction
Date Received
April 3, 2008
Date of Event
December 22, 2006
Report Date
December 22, 2006
Manufacturer
BAXTER HEALTHCARE PTE LTD
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE INFUSION PUMP WAS TESTED FOR FLOW ACCURACY AT 100ML/HOUR, THE INFUSION PUMP FAILED THE ACCURACY TEST. THE SPECIFICATION OF THIS DEVICE IS +/-5%. THE CONDITION OF ACCURACY FAILURE WAS CONFIRMED ON SITE AT THE CUSTOMER LOCATION BY A FIELD SERVICE ENGINEER. THE PUMP HEAD MODULE WAS REPLACED. SERVICE OF THE DEVICE WAS CONDUCTED ON-SITE.

Description of Event or Problem · 1

THE BAXTER FIELD SERVICE ENGINEER FOUND THAT THE DEVICE FAILED ACCURACY TESTING WHILE SERVICING THIS DEVICE ON SITE AT THE CUSTOMER LOCATION. THE HOSPITAL REPRESENTATIVE STATED THAT THERE WERE NO REPORTS OF PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE LTD NA NA

Patients

Seq Age Sex Outcome Treatment
1