FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1240783 · Received November 25, 2008

Report

Report Number
6000001-2007-04135
Event Type
Malfunction
Date Received
November 25, 2008
Date of Event
January 1, 2007
Report Date
January 15, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE INFUSION PUMP WAS TESTED FOR FLOW ACCURACY AT 100 ML/HOUR, THE INFUSION PUMP FAILED THE ACCURACY TEST. THE SPECIFICATION OF THIS DEVICE IS +/-5%. THE CHANNEL B PUMP HEAD MODULE WAS REPLACED.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED AN INFUSION PUMP WITH AN ACCURACY ISSUE ON CHANNEL B DURING BIOMED TESTING. THE HOSPITAL REPRESENTATIVE STATED THAT THERE WERE NO REPORTS OF PATIENT INJURY OR MEDICAL INTERVENTION. 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