BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BAXTER INFUSION PUMP

    MDR report key: 1220662 · Received November 3, 2008

    Report

    Report Number
    MW5008843
    Event Type
    Malfunction
    Date Received
    November 3, 2008
    Date of Event
    October 29, 2008
    Report Date
    November 3, 2008
    Manufacturer
    BAXTER INTERNATIONAL
    Product Code
    FRN
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    NURSE SET THE DEVICE TO DELIVER THE SODIUM CHLORIDE IN 8 HOURS. WHEN SHE RETURNED THE CONTENTS OF THE BAG WAS EMPTY. REPORTED TO SUPERVISOR AND PHARMACY. DATES OF USE: 2008.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER INFUSION PUMP INFUSION PUMP FRN BAXTER INTERNATIONAL COLLEAGUE CXE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other