FDA Adverse Event
Malfunction
Summary report: N
COLLEAGUE CX VOLUMETRIC INFUSION PUMP
MDR report key: 1200766
·
Received October 20, 2008
Report
- Report Number
- 6000001-2007-00677
- 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
- 6000001-3/15/05-007-C
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, 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. THE REPORTED CONDITION OF FAILURE CODE 810:04 WAS CONFIRMED, HOWEVER IT COULD NOT BE DUPLICATED. THEREFORE, NO FURTHER CORRECTION WAS MADE. DEVICE REPAIRED ON SITE.
Description of Event or Problem · 1
THE FIELD SERVICE ENGINEER REPORTED A PUMP WITH FAILURE CODE 810:04. THIS PROBLEM WAS IDENTIFIED DURING PATIENT USE. 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 |