FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3 VOLUMETRIC INFUSION PUMP

MDR report key: 1150133 · Received August 29, 2008

Report

Report Number
6000001-2008-00511
Event Type
Malfunction
Date Received
August 29, 2008
Date of Event
August 19, 2008
Report Date
August 19, 2008
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
PMA / PMN Number
K010566
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PUMP IS IN THE PROCESS OF BEING EVALUATED. A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF THE EVAL, OR IF ANY ADDITIONAL DETAILS BECOME AVAILABLE.

Description of Event or Problem · 1

THE FACILITY REPORTED AN INFUSION PUMP THAT WAS RUNNING AT A RATE OF 53 ML/HR BUT WAS SET TO RUN AT A RATE OF 50 ML/HR ON CHANNEL B. THIS CONDITION OCCURRED DURING BIO-MED TESTING. THERE WAS NO PT INJURY OR MEDICAL INTERVENTION NECESSARY ACCORDING TO THE HOSP REP. NO ADDITIONAL INFO IS AVAILABLE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1