FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1234085 · Received November 19, 2008

Report

Report Number
6000001-2007-03466
Event Type
Malfunction
Date Received
November 19, 2008
Date of Event
January 1, 2007
Report Date
January 9, 2007
Manufacturer
BAXTER HEALTHCARE PTE.LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: EVALUATION WAS PERFORMED ON-SITE AND THE REPORTED CONDITION WAS CONFIRMED. INSPECTION OF THE PUMP REVEALED DEPLETED MAIN BATTERIES HAD 7 DISCHARGES BELOW ALARM THRESHOLD. THE MAIN BATTERIES WERE REPLACED. THE PUMP WAS TESTED FOR PROPER OPERATION AND PUMP FOUND TO FUNCTION PROPERLY. 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 FACILITY REPORTED AN INFUSION PUMP WITH DEPLETED BATTERIES. THE EVENT WAS REPORTED TO HAVE OCCURRED DURING BIO-MED TESTING. ACCORDING TO THE HOSPITAL 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 COLLEAGUE CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE.LTD. N/A NA

Patients

Seq Age Sex Outcome Treatment
1