FDA Adverse Event Malfunction Summary report: N

FLO-GARD 6201 VOLUMETRIC INFUSION PUMP

MDR report key: 1232928 · Received November 18, 2008

Report

Report Number
6000001-2007-06230
Event Type
Malfunction
Date Received
November 18, 2008
Date of Event
April 17, 2007
Report Date
April 17, 2007
Manufacturer
BAXTER HEALTHCARE (SG)
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE PUMP WAS EVALUATED BY A BAXTER SERVICE TECHNICIAN. THE REPORTED CONDITION WAS CONFIRMED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS BEING INVESTIGATED.

Description of Event or Problem · 1

THE DEVICE WAS RETURNED FOR SERVICE. DURING SERVICE BY BAXTER, A CRACKED DOOR LATCH WAS FOUND. ACCORDING TO THE HOSPITAL REPRESENTATIVE, NO PATIENT INJURY OR MEDICAL INTERVENTION HAD BEEN REPORTED RELATED TO THE DEVICE. NO ADDITIONAL INFORMATION IS 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