FDA Adverse Event Malfunction Summary report: N

AS50 INFUSION PUMP

MDR report key: 1232099 · Received November 7, 2008

Report

Report Number
6000001-2008-00731
Event Type
Malfunction
Date Received
November 7, 2008
Date of Event
October 1, 2008
Report Date
October 22, 2008
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
FPA
PMA / PMN Number
K961225
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT YET BEEN RECEIVED IN BAXTER FOR EVALUATION. A FOLLOW-UP REPORT WILL BE SUBMITTED SHOULD THE DEVICE BE RECEIVED AND AN EVALUATION IS COMPLETED.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A PUMP THAT FAILED TO GIVE AN OCCLUSION ALARM. THIS EVENT OCCURRED AT AN UNKNOWN TIME. NO PATIENT INJURY OR MEDICAL INTERVENTION WAS REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.

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