FDA Adverse Event Malfunction Summary report: N

SPECTRUM IQ

MDR report key: 18508678 · Received January 12, 2024

Report

Report Number
1314492-2023-05028
Event Type
Malfunction
Date Received
January 12, 2024
Date of Event
December 20, 2023
Report Date
December 18, 2024
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K222048
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

CORRECTION: D1: BRAND NAME, D4: MODEL #, D4: UNIQUE IDENTIFIER (UDI) #, G4: COMBINATION PRODUCT ADDITIONAL INFORMATION: H6, H11. H11: A SERVICE HISTORY REVIEW WAS PERFORMED AND REVEALED THAT THE DEVICE HAS NO PREVIOUS SERVICE EVENTS; THEREFORE, SERVICING DID NOT CAUSE OR CONTRIBUTE TO THE REPORTED EVENT. THE DEVICE WAS NOT RECEIVED FOR EVALUATION; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. THE ISSUE REPORTED BY THE CUSTOMER ALIGNS WITH THE ISSUE DESCRIBED BY FA 2024-023. THE ISSUE IS RELATED TO THE BATTERY MODULE SOFTWARE, AND THE STUCK MESSAGES CONDITION DOES NOT AFFECT THE USER'S ABILITY TO PROGRAM THE DEVICE AND DOES NOT AFFECT FUNCTION OF THE DEVICE. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A SPECTRUM IQ PUMP WAS NOT SENDING STATUS MESSAGES WHILE CONTINUING TO RUN THE PROGRAMMED THERAPY. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2099924 SPECTRUM IQ PUMP, INFUSION FRN BAXTER HEALTHCARE CORPORATION 3570009 NA

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown NI.