FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1200964 · Received October 20, 2008

Report

Report Number
6000001-2007-00330
Event Type
Malfunction
Date Received
October 20, 2008
Date of Event
December 1, 2006
Report Date
December 7, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, 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 03, 2007. EVALUATION SUMMARY: THE EVALUATION WAS COMPLETED AND THE PUMP WAS TESTED FOR ACCURACY. THE CUSTOMER REPORTED CONDITION OF UNDER-INFUSING COULD NOT BE CONFIRMED DURING SERVICE TESTING.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A PUMP THAT WAS UNDER-INFUSING DURING BIO-MED TESTING. ACCORDING TO THE FACILITY REPRESENTATIVE, THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION REPORTED. NO ADDITIONAL INFORMATION WAS PROVIDED.

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