FDA Adverse Event Malfunction Summary report: N

COLLEAGUE TRIPLE CHANNEL VOLUMETRIC INFUSION PUMP

MDR report key: 1161417 · Received September 17, 2008

Report

Report Number
6000001-2007-04271
Event Type
Malfunction
Date Received
September 17, 2008
Date of Event
January 20, 2007
Report Date
January 20, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING RESUBMITTED IN ACCORDANCE WITH INSTRUCTIONS FROM FDA TO ADDRESS A MANUFACTURER REPORT SEQUENCE NUMBER ISSUE THAT OCCURRED WHEN THIS MDR OR SUPPLEMENT WAS ORIGINALLY SUBMITTED TO THE FDA ON FEB 08 2007. EVALUATION SUMMARY: THE CONDITION OF THE PUMP'S AIR IN LINE PRINTED CIRCUIT BOARD (AIL PCB) BEING OUT OF CALIBRATION WAS CONFIRMED. THE PUMP'S AIL PCB WAS RECALIBRATED.

Description of Event or Problem · 1

DURING PRODUCT EVALUATION, THE PUMP'S AIR IN LINE PRINTED CIRCUIT BOARD (AIL PCB) WAS FOUND TO BE OUT OF CALIBRATION. 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 TRIPLE CHANNEL VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1