FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2945874 · Received February 6, 2013

Report

Report Number
1416980-2013-03051
Event Type
Malfunction
Date Received
February 6, 2013
Date of Event
January 1, 2013
Report Date
January 15, 2013
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915522
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE IS CURRENTLY IN THE PROCESS OF BEING EVALUATED ON-SITE BY A BAXTER FIELD SERVICE TECHNICIAN. A FOLLOW-UP REPORT WILL BE FILED UPON COMPLETION OF THE EVALUATION OR IF ANY ADDITIONAL DETAILS BECOME AVAILABLE.

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE REPORTED CONDITION OF "F-38 ALARM" WAS CONFIRMED DURING DEVICE EVALUATION. THE ROOT CAUSE WAS DUE TO DEFECTIVE FORCE SENSING RESISTORS (FSRS), WHICH WERE REPLACED TO RESOLVE THE REPORTED CONDITION. A SERVICE HISTORY REVIEW WAS PERFORMED REVEALING THE REPORTED CONDITION IS NOT RELATED TO ANY PREVIOUS CUSTOMER SERVICE REQUEST ON THIS PUMP.

Additional Manufacturer Narrative · 1

(B)(4). SHOULD ADDITIONAL INFORMATION BE RECEIVED, A FOLLOW-UP MEDWATCH WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED TO BAXTER (B)(4) THAT A FLOGARD INFUSION PUMP HAD AN F-38 ALARM. IT IS UNKNOWN WHEN THIS CONDITION OCCURRED. THERE WAS NO REPORT OF PATIENT INVOLVEMENT; THEREFORE, NO REPORT OF PATIENT INJURY, MEDICAL INTERVENTION, OR ADVERSE REACTION IS ASSOCIATED WITH THE REPORTED CONDITION. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
51020 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1