BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BAXTER COLLEAGUE IV PUMP

    MDR report key: 239692 · Received September 9, 1999

    Report

    Report Number
    239692
    Event Type
    Injury
    Date Received
    September 9, 1999
    Date of Event
    September 6, 1999
    Report Date
    September 8, 1999
    Manufacturer
    BAXTER HEALTHCARE, INC.
    Product Code
    FRN
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CO, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BAXTER IV PUMP TRIPLE CHANNEL GAVE A SHORT BEEP THEN TURNED ITSELF OFF. NO ALARM SOUNDED. PT RECEIVING DOPAMINE/DOBUTAMINE VIA PUMP WHICH REQUIRED IMMEDIATE CHANGE TO ANOTHER PUMP. PT HAD HYPOTENSIVE EVENT THAT REVERSED W/O ADVERSE OUTCOME ONCE IV'S RESTARTED W/NEW PUMP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER COLLEAGUE IV PUMP TRIPLE CHANNEL IV INFUSION PUMP FRN BAXTER HEALTHCARE, INC. 2M8153 *

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Required Intervention VENTILATOR/ICU PT.