FDA Adverse Event Malfunction Summary report: N

FLO-GARD 6301 VOLUMETRIC INFUSION PUMP

MDR report key: 1233020 · Received November 18, 2008

Report

Report Number
6000001-2007-06204
Event Type
Malfunction
Date Received
November 18, 2008
Date of Event
March 1, 2007
Report Date
March 29, 2007
Manufacturer
BAXTER HEALTHCARE (SG)
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE FACILITY REPRESENTATIVE REPORTED "PUMP 1 NEEDS NEW DOOR LATCH AND DOOR/PUMP 2 NEEDS NEW LATCH" DUING BIO-MED TESTING. EVALUATION SUMMARY: THE PUMP WAS EVALUATED BY A BAXTER SERVICE TECHNICIAN. INSPECTION OF THE DEVICE FOUND BROKEN DOORS WITH BROKEN DOOR LATCHES ON CHANNELS 1 AND 2. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS BEING INVESTIGATED UNDER CAPA.

Description of Event or Problem · 1

THE DEVICE WAS RETURNED FOR SERVICE. DURING SERVICE BY BAXTER, BROKEN DOORS WITH BROKEN DOOR LATCHES ON CHANNELS 1 AND 2 WERE 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 6301 VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE (SG) NA NA

Patients

Seq Age Sex Outcome Treatment
1