FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1051219 · Received May 23, 2008

Report

Report Number
6000001-2008-00341
Event Type
Malfunction
Date Received
May 23, 2008
Date of Event
May 1, 2008
Report Date
May 21, 2008
Manufacturer
BAXTER HEALTHCARE PTE. LTD
Product Code
FRN
PMA / PMN Number
K010566
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN REQUESTED BY BAXTER FOR EVAL BUT HAS NOT YET BEEN RECEIVED. SHOULD THE PUMP BE RECEIVED FOR EVAL, A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF THE EVAL OR IF ADD'L INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

A BAXTER FIELD SERVICE ENGINEER REPORTED AN INFUSION PUMP THAT WAS NOT DETECTING AIR (FAILURE TO ALARM) ON CHANNEL B. THE EVENT WAS REPORTED TO HAVE OCCURRED DURING BIOMEDICAL TESTING. ACCORDING TO THE HOSPITAL REP, NO PT INJURY OR MEDICAL INTERVENTION HAD BEEN REPORTED RELATED TO THE DEVICE. NO ADD'L INFO OR CONTACT WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP 80FRN FRN BAXTER HEALTHCARE PTE. LTD

Patients

Seq Age Sex Outcome Treatment
1