FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1160336 · Received September 16, 2008

Report

Report Number
6000001-2007-03285
Event Type
Malfunction
Date Received
September 16, 2008
Date of Event
December 1, 2006
Report Date
December 27, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE REPORTED CONDITION OF A FAILED PUMP WAS CONFIRMED. DURING INSPECTION OF THE DEVICE FAILURE CODE 570:320:844:0000 WAS FOUND. INSPECTION OF THE DEVICE FOUND THAT THE FAILURE CODE AND REPORTED CONDITION WAS DUE TO DEPLETED AND POTENTIALLY DAMAGE BATTERIES. THE BATTERIES WERE REPLACED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS CURRENTLY BEING INVESTIGATED UNDER CAPA.

Description of Event or Problem · 1

THE FACILITY REPORTED TO CUSTOMER SERVICE A FAILED PUMP. IT IS UNKNOWN WHEN THIS EVENT OCCURRED. THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION NECESSARY ACCORDING TO THE HOSPITAL REPRESENTATIVE. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1