FDA Adverse Event Malfunction Summary report: N

FLO-GARD 6201 VOLUMETRIC INFUSION PUMP

MDR report key: 1231490 · Received November 18, 2008

Report

Report Number
6000001-2007-05480
Event Type
Malfunction
Date Received
November 18, 2008
Date of Event
March 1, 2007
Report Date
March 13, 2007
Manufacturer
BAXTER HEALTHCARE (SG)
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED FOR EVALUATION, HOWEVER EVALUATION IS NOT COMPLETE. A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF THE EVALUATION OR IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A BROKEN DOOR DURING BIO-MED TESTING. ALTHOUGH BAXTER ATTEMPTED TO OBTAIN INFORMATION, DETAILS WERE NOT AVAILABLE REGARDING ADDITIONAL CONTACT INFORMATION. ACCORDING TO THE FACILITY REPRESENTATIVE, NO PATIENT INJURY OF MEDICAL INTERVENTION HAD BEEN REPORTES RELATED TO THE DEVICE. NO ADDITIONAL INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLO-GARD 6201 VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE (SG) NA NA

Patients

Seq Age Sex Outcome Treatment
1