FDA Adverse Event Malfunction Summary report: N

FLO-GARD 6201 VOLUMETRIC INFUSION PUMP

MDR report key: 1233091 · Received November 18, 2008

Report

Report Number
6000001-2007-06250
Event Type
Malfunction
Date Received
November 18, 2008
Date of Event
April 2, 2007
Report Date
April 2, 2007
Manufacturer
BAXTER HEALTHCARE (SG)
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE FACILITY REPRESENTATIVE REPORTED "OCCLUSION ERROR" DURING BIO-MED TESTING. EVALUATION SUMMARY: THE PUMP WAS EVALUATED BY A BAXTER SERVICE TECHNICIAN. THE REPORTED CONDITION OF OCCLUSION ERROR WAS CONFIRMED, CAUSED BY A BROKEN DOOR AND LATCH. 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 BROKEN DOOR AND LATCH WAS FOUND. ACCORDING TO THE FACILITY REPRESENTATIVE, NO PATIENT INJURY OR MEDICAL INTERVENTION HAD BEEN REPORTED RELATED TO THE DEVICE. NO ADDITIONAL INFORMATION OR CONTACT 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