BEUDAMED
    FDA Adverse Event Other Summary report: N

    BAXTER

    MDR report key: 109740 · Received July 28, 1997

    Report

    Report Number
    109740
    Event Type
    Other
    Date Received
    July 28, 1997
    Date of Event
    June 20, 1997
    Report Date
    June 24, 1997
    Manufacturer
    BAXTER HEALTHCARE CORP.
    Product Code
    FRN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    ME, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    NTG DRIP INSTALLED. STAFF FAILED TO REMOVE CLAMP FROM LINE ON SIDE 1 OF DOUBLE PUMP. AND NO NTG DELIVERED. PUMP COUNTED DOWN TO EMPTY IN SPITE OF THIS, BUT FAILED TO BEEP OCCLUSION. IV BOTTLE REMAINED FULL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER DUAL CHANNEL VOLUMETRIC INFUSION PUMP FRN BAXTER HEALTHCARE CORP. FLO-GARD 6300 *

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other