FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3 VOLUMETRIC INFUSION PUMP

MDR report key: 1832726 · Received September 13, 2010

Report

Report Number
6000001-2007-01637
Event Type
Malfunction
Date Received
September 13, 2010
Date of Event
December 21, 2006
Report Date
December 21, 2006
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING RESUBMITTED IN ACCORDANCE WITH INSTRUCTIONS FROM FDA TO ADDRESS A MANUFACTURER REPORT SEQUENCE NUMBER ISSUE THAT OCCURRED WHEN THIS MDR OR SUPPLEMENT WAS ORIGINALLY SUBMITTED TO THE FDA ON (B)(6), 2007. EVALUATION SUMMARY: THE CONDITION OF DEPLETED BATTERIES WAS CONFIRMED. THE BATTERIES WERE REPLACED DUE TO POTENTIAL DAMAGE. THIS ISSUE IS CURRENTLY BEING INVESTIGATED UNDER (B)(4). REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. (B)(4).

Description of Event or Problem · 1

THE FACILITY RETURNED THE DEVICE FOR SERVICE. DURING SERVICE THE BAXTER REPAIR TECHNICIAN NOTED DEPLETED BATTERIES. THE HOSPITAL REPRESENTATIVE STATED THAT THERE HAVE BEEN NO REPORTS OF ANY PATIENT INCIDENT INVOLVING THIS PUMP. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLEAGUE 3 VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1