FDA Adverse Event Malfunction Summary report: N

AS50 INFUSION PUMP

MDR report key: 1220771 · Received October 31, 2008

Report

Report Number
6000001-2008-00689
Event Type
Malfunction
Date Received
October 31, 2008
Date of Event
October 13, 2008
Report Date
October 14, 2008
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
FPA
PMA / PMN Number
K961225
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED IN BAXTER, BUT HAS NOT YET BEEN EVALUATED. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN AN EVALUATION IS COMPLETED.

Description of Event or Problem · 1

THE FACILITY REP REPORTED A PUMP WITH AN OVERINFUSION DURING PT USE. CONTACT WITH THE FACILITY HAS NOT PRODUCED ANY ADD'L INFO. THERE WAS NO PT INJURY OR MEDICAL INTERVENTION REQUIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AS50 INFUSION PUMP 80FPA FPA BAXTER HEALTHCARE CORP.

Patients

Seq Age Sex Outcome Treatment
1