FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1193068 · Received October 13, 2008

Report

Report Number
6000001-2007-03266
Event Type
Malfunction
Date Received
October 13, 2008
Date of Event
January 1, 2007
Report Date
January 9, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, 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 JAN 29, 2007. EVALUATION SUMMARY: THE REPORTED CONDITION OF FAILURE CODE 570:320:844:0000 WITH 278 BATTERY DISCHARGES BELOW THE ALARM THRESHOLD WAS CONFIRMED. THESE INDICATE THAT THE PUMP'S BATTERIES ARE DAMAGED, THEREFORE THEY WERE 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

THE FACILITY REPORTED A PUMP WITH FAILURE CODE 570:320:844:0000 WITH 278 BATTERY DISCHARGES BELOW THE ALARM THRESHOLD. THIS OCCURRED DURING BIO-MED TESTING. 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