FDA Adverse Event Malfunction Summary report: N

COLLEAGUE VOLUMETRIC INFUSION PUMP

MDR report key: 1200745 · Received October 20, 2008

Report

Report Number
6000001-2007-00694
Event Type
Malfunction
Date Received
October 20, 2008
Date of Event
December 1, 2006
Report Date
December 6, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING SUBMITTED 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 05, 2007. EVALUATION SUMMARY:THE REPORTED CONDITION OF UNKNOWN ISSUE WAS CONFIRMED AS DUE TO DEPLETED MAIN BATTERIES DURING PRODUCT EVALUATION. INSPECTION OF THE DEVICE FOUND THE PUMP'S MAIN BATTERIES WERE POTENTIALLY DAMAGED AND THEREFORE THE BATTERIES WERE REPLACED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS CURRENTLY BEING INVESTIGATED.

Description of Event or Problem · 1

THE FACILITY REPORTED A PUMP WITH AN UNKNOWN ISSUE. IT IS UNKNOWN WHEN THIS EVENT OCCURRED. THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION NECESSARY ACCORDING TO THE HOSPITAL REPRESENTATIVE. NO ADDITIONAL INFORMATION 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