FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2834528 · Received November 15, 2012

Report

Report Number
1416980-2012-05331
Event Type
Malfunction
Date Received
November 15, 2012
Date of Event
October 24, 2012
Report Date
October 24, 2012
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915523
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PR
Reporter Occupation
SERVICE AND TESTING PERSONNEL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE HAS BEEN RECEIVED BY BAXTER, AND THE CONDITION WAS CONFIRMED BY SERVICE. THIS COMPLAINT IS AN ANCILLARY SERVICE EVENT. THE CAUSE WAS IDENTIFIED TO BE A DEFECTIVE LEFT FORCE SENSING RESISTOR, AS THE COMPONENT WAS OUT OF SPECIFICATION.¿ TO CORRECT THIS CONDITION BOTH FORCE SENSING RESISTORS ON PUMP ONE WERE REPLACED, AS PER SERVICE MANUAL. IF ANY ADDITIONAL INFORMATION IS RECEIVED, A FOLLOW-UP WILL BE SENT.

Description of Event or Problem · 1

DURING PRODUCT EVALUATION BY BAXTER PERSONNEL, A FLOGARD INFUSION PUMP WAS FOUND TO HAVE EXPERIENCED FAILURE CODE 38 ON THE PUMP ONE. THIS WAS NOT REPORTED BY THE CUSTOMER. THIS CONDITION HAD THE POTENTIAL TO INTERRUPT DELIVERY. THERE WAS NO PATIENT INVOLVEMENT; THEREFORE, NO PATIENT INJURY, MEDICAL INTERVENTION, OR ADVERSE REACTION IS ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS 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