FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2161410 · Received July 13, 2011

Report

Report Number
6000001-2011-11781
Event Type
Malfunction
Date Received
July 13, 2011
Date of Event
May 31, 2011
Report Date
June 17, 2011
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K915522
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE CUSTOMER'S REPORTED CONDITION OF A FLO-GARD INFUSION PUMP WITH A COMMON FAILURE WAS NOT CONFIRMED OR DUPLICATED DURING PRODUCT EVALUATION. THEREFORE, NO ASSIGNABLE CAUSE COULD BE PROVIDED FOR THIS CONDITION AND NO REPAIR WAS NECESSARY. A SERVICE HISTORY REVIEW REVEALED NO PREVIOUS SERVICE EVENTS WERE RELATED TO THE REPORTED CONDITION. BAXTER DISCONTINUED SERVICE AND CEASED ALL DESIGN RELATED SUPPORT ON FLO-GARD 2M8063 (6201) AND 2M8064 (6301) IN THE U.S. REGION AS OF DECEMBER 31ST, 2010 (REFER TO END OF SERVICE NOTIFICATION (B)(4)). BAXTER CONTINUES TO SUPPORT THE PRODUCT IN (B)(4) AND WILL DO SO UNTIL PARTS REMAIN AVAILABLE. PER THE FLO-GARD QUALITY PLAN ((B)(4)) BAXTER WILL CONTINUE TO COLLECT PRODUCT COMPLAINTS BUT PERIODIC MONITORING/TRENDING AND ANALYSES OF THE U.S. COMPLAINTS FOR PRODUCT IMPROVEMENTS WILL NO LONGER BE REQUIRED. HOWEVER, BAXTER WILL CONTINUE TO MONITOR AND REPORT ON DEATH AND SERIOUS INJURY (DSI) EVENTS AND FOLLOW EXISTING ESCALATION PROCESSES (E.G., HHA, MDR, FCA ETC.) TO ASSESS THE IMPACT ON PATIENT SAFETY.

Additional Manufacturer Narrative · 1

(B)(4). A FOLLOW-UP MEDWATCH REPORT WILL BE SUBMITTED WHEN THE EVALUATION RESULTS OR IF ADDITIONAL INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE CONTACTED BAXTER TO REPORT A "COMMON FAILURE." THERE WAS NO PATIENT INVOLVEMENT. THE EVENT OCCURRED UPON POWER ON IN THE EMERGENCY ROOM. THERE WAS NO ADVERSE EVENT, PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS REPORT. THERE IS NO FURTHER COMPLAINT INFORMATION AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE CORPORATION

Patients

Seq Age Sex Outcome Treatment
1