FDA Adverse Event Malfunction Summary report: N

PCA II PUMP

MDR report key: 1243111 · Received November 21, 2008

Report

Report Number
6000001-2008-00779
Event Type
Malfunction
Date Received
November 21, 2008
Date of Event
November 3, 2008
Report Date
November 4, 2008
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
MEA
PMA / PMN Number
K926385
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS DEVICE HAS BEEN RECEIVED IN BAXTER, BUT HAS NOT YET BEEN EVALUATED. A FOLLOW-UP REPORT WILL BE SUBMITTED WHEN AN EVALUATION IS COMPLETED.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A PUMP THAT FAILS TO ALARM AT THE 5ML LEVEL AS INTENDED. THIS EVENT OCCURRED DURING BIOMED TESTING. NO PT INJURY OR MEDICAL INTERVENTION WAS REPORTED. NO ADDITIONAL INFO IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PCA II PUMP 80FRN MEA BAXTER HEALTHCARE CORP.

Patients

Seq Age Sex Outcome Treatment
1