FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 1832759 · Received September 13, 2010

Report

Report Number
6000001-2007-02428
Event Type
Malfunction
Date Received
September 13, 2010
Date of Event
January 2, 2007
Report Date
January 2, 2007
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Removal / Correction Number
CONTINUED ON H10
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, 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)(4) 2007. EVALUATION SUMMARY: THE CONDITION OF DAMAGED BATTERIES WITH 3 BATTERY DISCHARGES BELOW THE ALARM THRESHOLD WAS CONFIRMED. THE PUMP'S BATTERIES WERE REPLACED. REVIEW OF THE COMPLAINT HISTORY REVEALS SIMILAR REPORTS HAVE BEEN RECEIVED FOR THIS PRODUCT FOR THE REPORTED ISSUE. THIS ISSUE IS BEING INVESTIGATED UNDER CAPA, MDQ-CAPA-132. 6000001-2/25/05-004-C, 6000001-12/13/05-019-C.

Description of Event or Problem · 1

DURING PRODUCT EVALUATION, THE PUMP'S BATTERIES WERE FOUND TO BE DAMAGED WITH 3 BATTERY DISCHARGES BELOW THE ALARM THRESHOLD. 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 3CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1