FDA Adverse Event Malfunction Summary report: N

8015 ALARIS SYSTEM PC UNIT

MDR report key: 10893866 · Received November 24, 2020

Report

Report Number
2016493-2020-47517
Event Type
Malfunction
Date Received
November 24, 2020
Report Date
September 12, 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). PLEASE REFER TO FILE #2018-033277-264732 FROM CAD. (B)(4). NPI SN 13910032 MIKE LENHOF RAN A MANUAL BATTERY CONDITIONING ON PCU8015. THE BATTERY LOGS GAVE LB3 CAPACITY READING OF 5000 WHICH IS OUT SIDE THE SPECIFICATION OF 2700 - 4500 (BASED ON SB 592A). I RECOMMENDED MIKE TO CLEAR THE BATTERY LOGS AND RE-RUN THE MANUAL BATTERY CONDITIONING. OTHERWISE, HE WILL REPLACE A NEW BATTERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1360676 8015 ALARIS SYSTEM PC UNIT PUMP, INFUSION FRN CAREFUSION SD 8015 10885403801518

Patients

Seq Age Sex Outcome Treatment
1