FDA Adverse Event Malfunction Summary report: N

COLLEAGUE VOLUMETRIC INFUSION PUMP

MDR report key: 1170029 · Received September 24, 2008

Report

Report Number
6000001-2007-00794
Event Type
Malfunction
Date Received
September 24, 2008
Date of Event
January 3, 2007
Report Date
January 3, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
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 JAN 08, 2007. EVALUATION SUMMARY:EVALUATION WAS COMPLETED AND THE CONDITION OF DEPLETED BATTERY WAS CONFIRMED. INSPECTION OF THE DEVICE REVEALED POTENTIALLY DAMAGED BATTERIES. THE MAIN BATTERIES WERE REPLACED AND THE BAXTER TECHNICIAN TESTED THE DEVICE. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS BEING INVESTIGATED UNDER CAPA.

Description of Event or Problem · 1

THE DEVICE WAS RETURNED FOR SERVICE. DURING SERVICE BY BAXTER, DEPLETED MAIN BATTERIES WERE FOUND. ACCORDING TO THE HOSPITAL REPRESENTATIVE, NO PATIENT INJURY OR MEDICAL INTERVENTION HAD BEEN REPORTED RELATED TO THE DEVICE. NO ADDITIONAL INFORMATION OR CONTACT WAS AVAILABLE.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1