FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1240365 · Received November 25, 2008

Report

Report Number
6000001-2007-01460
Event Type
Malfunction
Date Received
November 25, 2008
Date of Event
November 1, 2006
Report Date
December 13, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A REQUEST FOR THE RETURN OF THE DEVICE HAS BEEN MADE. SHOULD THE PUMP BE RECEIVED FOR EVALUATION, A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF AN EVALUATION, OR IF ANY ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 1

THE FACILITY REPORTED AN INFUSION PUMP WITH FAILURE CODE 500:320. IT IS UNKNOWN WHEN THIS FAILURE CODE OCCURRED. IT IS ALSO UNKNOWN WHETHER THERE WAS ANY PATIENT INJURY OR MEDICAL INTERVENTION NECESSARY ACCORDING TO THE HOSPITAL REPRESENTATIVE. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1