FDA Adverse Event Malfunction Summary report: N

UO605 6464602 PCA II PUMP

MDR report key: 1230648 · Received November 17, 2008

Report

Report Number
6000001-2007-88712
Event Type
Malfunction
Date Received
November 17, 2008
Date of Event
June 1, 2007
Report Date
June 25, 2007
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K926385
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: DEVICE HAS BEEN REQUESTED FOR EVALUATION. IF DEVICE IS RECEIVED AND AN EVALUATION IS PERFORMED, A FOLLOW-UP MEDWATCH WILL BE FILED.

Description of Event or Problem · 1

CUSTOMER REPORTED BATTERY ACID WAS FOUND INSIDE THE PUMP. INFORMATION WAS NOT PROVIDED REGARDING WHETHER OR NOT THE PROBLEM OCCURRED DURING A PATIENT INFUSION. ALTHOUGH REQUESTED, NO ADDITIONAL INFORNMATION HAS BEEN OBTAINED ON THIS REPORT. NO PATIENT INVOLVEMENT HAS BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UO605 6464602 PCA II PUMP 80FRN FRN BAXTER HEALTHCARE CORPORATION N/A N/A

Patients

Seq Age Sex Outcome Treatment
1