FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2950993 · Received February 8, 2013

Report

Report Number
1416980-2013-03366
Event Type
Malfunction
Date Received
February 8, 2013
Date of Event
January 1, 2013
Report Date
January 16, 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). INITIAL EVALUATION CONFIRMED THE REPORTED CONDITION. THIS DEVICE IS CURRENTLY IN THE PROCESS OF BEING EVALUATED ON SITE. UPON COMPLETION OF BAXTER'S INVESTIGATION, A FOLLOW-UP WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

(B)(4). DEVICE EVALUATION: THE REPORTED CONDITION OF A DAMAGED BATTERY WAS CONFIRMED DURING DEVICE EVALUATION. THE ASSIGNABLE CAUSE WAS IDENTIFED AS A DEFECTIVE MAIN BATTERY. THE MAIN BATTERY WAS REPLACED TO RESOLVE THE REPORTE CONDITION. SHOULD RELEVANT ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW-UP MDR WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A FLOGARD INFUSION PUMP WITH A DAMAGED BATTERY. IT IS UNKNOWN WHEN THIS CONDITION OCCURRED. THERE WAS NO PATIENT INVOLVEMENT, INJURY, OR MEDICAL INTERVENTION RELATED TO THE DEVICE. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
54568 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1