FDA Adverse Event Malfunction Summary report: N

COLLEAGUE CX VOLUMETRIC INFUSION PUMP

MDR report key: 1241407 · Received November 25, 2008

Report

Report Number
6000001-2007-04149
Event Type
Malfunction
Date Received
November 25, 2008
Date of Event
January 1, 2007
Report Date
January 7, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE REPORTED CONDITION OF A PUMP WITH AN AIR SENSOR MALFUNCTION WAS CONFIRMED DURING PRODUCT EVALUATION. THIS EVENT WAS DUE TO A FAULTY PUMP HEAD MECHANISM. THE PUMP HEAD MECHANISM WAS 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.

Description of Event or Problem · 1

THE FACILITY REPORTED A PUMP WITH AN AIR SENSOR MALFUNCTION. IT IS UNKNOWN WHEN THIS EVENT OCCURRED. THERE WAS NO 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 CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1