FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1183599 · Received October 4, 2008

Report

Report Number
6000001-2007-00159
Event Type
Malfunction
Date Received
October 4, 2008
Date of Event
December 8, 2006
Report Date
December 8, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

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 03 2007. EVALUATION SUMMARY: THE CONDITION OF DEPLETED BATTERIES WAS CONFIRMED. INSPECTION OF THE DEVICE FOUND THAT THE PUMP'S BATTERIES WERE POTENTIALLY DAMAGED AND WERE THEREFORE REPLACED. 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

DURING SERVICE BY BAXTER, THE INFUSION PUMP WAS FOUND TO CONTAIN DEPLETED BATTERIES. 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 3CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. N/A NA

Patients

Seq Age Sex Outcome Treatment
1