FDA Adverse Event Malfunction Summary report: N

8015 ALARIS SYSTEM PC UNIT

MDR report key: 10893245 · Received November 24, 2020

Report

Report Number
2016493-2020-44978
Event Type
Malfunction
Date Received
November 24, 2020
Report Date
September 5, 2018
Manufacturer
CAREFUSION SD
Product Code
FRN
UDI-DI
10885403801518
PMA / PMN Number
K091308
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 1

THIS REPORTED EVENT AND SUBSEQUENT REPAIRS WERE INVESTIGATED THROUGH THE TSC TROUBLESHOOTING PROCESS. A REVIEW OF THE DEVICE SERVICE HISTORY RECORD WAS PERFORMED FROM THE DATE OF MANUFACTURE TO THE DATE CORRESPONDING TO THIS SERVICE NOTIFICATION NUMBER. THE DATABASE SHOWED NO QUALITY NOTIFICATIONS WERE OPENED FOR THE DEVICE. A REVIEW OF THE DEVICE HISTORY RECORD IN SAP FOR SN (B)(4) WAS PERFORMED FROM THE DATE OF THE MANUFACTURE TO DATE OF THE RELEASE OF PRODUCT, WHICH CONFIRMED THAT THIS DEVICE WAS NOT INVOLVED IN A PRODUCTION FAILURE, AND PRODUCT WAS NOT RETURNED FOR SERVICING WHICH NOT CORRELATES TO THE CUSTOMER REPORTED ISSUE. A REVIEW OF THE COMPLAINT HISTORY RECORD IN THE TRACKWISE WAS PERFORMED FOR THE SN (B)(4) WHICH CONFIRMED NO SIMILAR COMPLAINTS WITH THE SAME OR RELATED FAILURE MODE. THE CUSTOMER STATED THAT THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 1

(B)(4). 8015 110.5010 ERROR. ERROR OCCURRED AFTER UNIT WAS FLASHED USING ASM. BIOMED DID NOT HAVE CF CARDS TO DO THE FLASHING. IS WAITING ON A CF READER. LET HIM KNOW ONCE HE HAS A CF READER TO COPY THE KYB FILES AND RELOAD ONTO 8015. IF FAILS THE LOGIC BOARD WILL HAVE TO BE REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1361548 8015 ALARIS SYSTEM PC UNIT PUMP, INFUSION FRN CAREFUSION SD 8015 10885403801518

Patients

Seq Age Sex Outcome Treatment
1