FDA Adverse Event
Malfunction
Summary report: N
COLLEAGUE CX VOLUMETRIC INFUSION PUMP
MDR report key: 1234124
·
Received November 19, 2008
Report
- Report Number
- 6000001-2007-03330
- Event Type
- Malfunction
- Date Received
- November 19, 2008
- Date of Event
- January 22, 2007
- Report Date
- January 22, 2007
- Manufacturer
- BAXTER HEALTHCARE PTE. LTD.
- Product Code
- FRN
- Removal / Correction Number
- CONTINUED ON H10
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
EVALUATION SUMMARY: FAILURE CODE 570 WAS CONFIRMED IN THE EVENT HISTORY. FAILURE CODE 570 IS CAUSED BY LOW BATTERY VOLTAGE. INSPECTION OF THE DEVICE FOUND THAT THE PUMP'S BATTERIES WERE DEPLETED AND POTENTIALLY DAMAGED AND THEREFORE REPLACED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS CURRENTLY BEING INVESTIGATED UNDER CAPA.
Description of Event or Problem · 1
DURING SERVICE BY BAXTER, THE INFUSION PUMP WAS FOUND TO CONTAIN FAILURE CODE 570. 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 |