FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 2843575 · Received October 24, 2012

Report

Report Number
1314492-2012-00363
Event Type
Malfunction
Date Received
October 24, 2012
Report Date
September 24, 2012
Manufacturer
SIGMA HEALTHCARE CORP.
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). SIGMA EVALUATED THE DEVICE IN QUESTION. THE SIGMA DEVICE EVALUATION FOUND THE #2, #3, #4, #5, #6, #7, #8, #9 AND (.) KEYS TO BE INOPERABLE. IT WAS OBSERVED THAT WHEN ANY REMAINING FUNCTIONAL KEYS ARE SELECTED, AN AUTOMATIC OUTPUT OF THE #3 KEY WILL OCCUR FOLLOWING THE SELECTED KEY'S FUNCTION (E.G. WHEN THE #1 KEY IS PRESSED 13 WILL BE DISPLAYED. WHEN IN ALPHABETIC MODE AND THE ABC KEY IS SELECTED, AG WILL BE DISPLAYED INTERFERING WITH THE MDL DRUG SEARCH). SIGMA'S ENGINEERING INVESTIGATION IS IN PROGRESS. WHEN COMPLETE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP KEYPAD WAS INOPERABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPECTRUM INFUSION PUMP INFUSION PUMP FRN SIGMA HEALTHCARE CORP. 35700

Patients

Seq Age Sex Outcome Treatment
1