FDA Adverse Event Malfunction Summary report: N

GEMSTAR 7 SP NEW

MDR report key: 2182749 · Received July 11, 2011

Report

Report Number
2921482-2011-00091
Event Type
Malfunction
Date Received
July 11, 2011
Date of Event
June 1, 2011
Report Date
June 9, 2011
Manufacturer
HOSPIRA, INC.
Product Code
FRN
PMA / PMN Number
K083019
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THE DEVICE DID NOT SOUND AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION. THIS WAS DUE TO A BROKEN BOTTOM PRINTED CIRCUIT BOARD. THE CAUSE OF THE BROKEN BOTTOM PWA COULD NOT BE DETERMINED. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

DURING VERIFICATION TESTING AT THE SERVICE CENTER, THE DEVICE DID NOT SOUND AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GEMSTAR 7 SP NEW 80FRN FRN HOSPIRA, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA