FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2220691 · Received August 23, 2011

Report

Report Number
6000001-2011-20387
Event Type
Malfunction
Date Received
August 23, 2011
Date of Event
July 31, 2011
Report Date
August 3, 2011
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915522
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PR
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE REPORTED CONDITION OF A FLOGARD INFUSION PUMP WITH A BATTERY PROBLEM WAS CONFIRMED AND REPRODUCED DURING PRODUCT EVALUATION. THIS CONDITION WAS CAUSED BY A DEFECTIVE MAIN BATTERY. THE MAIN BATTERY WAS REPLACED TO CORRECT THIS CONDITION. BAXTER WILL CONTINUE TO MONITOR SIMILAR REPORTS TO DETERMINE IF FURTHER ACTIONS ARE REQUIRED.

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE HAS BEEN RECEIVED AND IS AVAILABLE FOR EVALUATION. A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF THE EVALUATION OR IF ANY ADDITIONAL DETAILS BECOME AVAILABLE.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE CONTACTED BAXTER TO REPORT A FLOGARD PUMP IN WHICH THERE WAS A PROBLEM WITH THE BATTERY. THIS CONDITION HAS THE POTENTIAL TO CAUSE AN INTERRUPTION OF DELIVERY. THERE WAS NO PATIENT INVOLVEMENT. THE EVENT OCCURRED UPON POWER UP IN THE BIOMEDICAL SERVICE DEPARTMENT. 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 - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1