FDA Adverse Event
Malfunction
Summary report: N
COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP
MDR report key: 1815986
·
Received August 26, 2010
Report
- Report Number
- 6000001-2007-02134
- Event Type
- Malfunction
- Date Received
- August 26, 2010
- Date of Event
- December 22, 2006
- Report Date
- December 22, 2006
- Manufacturer
- BAXTER HEALTHCARE PTE. LTD.
- Product Code
- FRN
- Removal / Correction Number
- CONTINUED ON H10
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(4).EVALUATION SUMMARY:THE DEVICE EVALUATION WAS COMPLETED AND FAILURE CODE 570:320:844:000, FOUND TO BE DUE TO THE DEPLETED (DAMAGED) BATTERY CONDITION, WAS CONFIRMED. SERVICE INSTALLED NEW BATTERIES AND TESTED THE DEVICE. A REVIEW OF THE COMPLAINT HISTORY REVEALED SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT AND THE REPORTED ISSUE. THIS ISSUE IS BEING INVESTIGATED UNDER CAPA, (B)(4).
Description of Event or Problem · 1
THE DEVICE WAS RECEIVED FOR SERVICE. DURING SERVICE TESTING, FAILURE CODE 570:320:844:0000 WAS FOUND. ACCORDING TO THE HOSPITAL REPRESENTATIVE, THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION REPORTED. NO ADDITIONAL INFORMATION WAS PROVIDED.
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 |