BEUDAMED
    FDA Adverse Event Death Summary report: N

    BAXTER IV PUMP

    MDR report key: 1553140 · Received December 4, 2009

    Report

    Report Number
    1553140
    Event Type
    Death
    Date Received
    December 4, 2009
    Date of Event
    October 19, 2009
    Report Date
    December 4, 2009
    Manufacturer
    BAXTER
    Product Code
    FRN
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    KY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IN 2009, PT WAS STATUS POST CODE BLUE RESUSCITATION AND MOVED TO SCU. THE FOLLOWING DAY, PT RECEIVING NEO DRIP VIA IV PUMP. IV PUMP STALLED (FOR 1-2 MINUTES) DUE TO EQUIPMENT MALFUNCTION. THREE LIGHTS ON PUMP WERE BEEPING. IV PUMP WAS REPLACED. PT BECAME BRADYCARDIAC AND WENT IN TO CARDIOPULMONARY ARREST AGAIN, RESUSCITATION EFFORTS UNSUCCESSFUL. IV PUMP CHECKED BY BIOMED AND NO MALFUNCTION WAS FOUND. NURSE EDUCATION ON USE OF PUMP. DETERMINATION WAS MADE THAT THE DEATH OF THIS PT WAS NOT A DIRECT RESULT CAUSED BY EQUIPMENT MALFUNCTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER IV PUMP IV PUMP FRN BAXTER 1103

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Death| O