FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1200426 · Received October 20, 2008

Report

Report Number
6000001-2007-01661
Event Type
Malfunction
Date Received
October 20, 2008
Date of Event
December 1, 2006
Report Date
December 22, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING SUBMITTED IN ACCORDANCE WITH INSTRUCTION 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 16, 2007. EVALUATION SUMMARY:THE CONDITION OF DEPLETED BATTERIES WAS CONFIRMED. THIS DEVICE WAS EVALUATED AT THE CUSTOMER'S FACILITY ON 12/22/2006. THE BATTERIES WERE REPLACED DUE TO POTENTIAL DAMAGE. THIS ISSUE IS CURRENTLY BEING INVESTIGATED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE.

Description of Event or Problem · 1

THE BAXTER FIELD SERVICE ENGINEER NOTED AN INFUSION PUMP WITH DEPLETED BATTERIES. INFORMATION WAS NOT PROVIDED REGARDING WHETHER OR NOT THE FAILURE OCCURRED DURING A PATIENT INFUSION. THE HOSPITAL REPRESENTATIVE STATED THAT THERE WERE NO REPORTS OF PATIENT INJURY OR MEDICAL INTERVENTION. 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