FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2982453 · Received February 28, 2013

Report

Report Number
1416980-2013-04891
Event Type
Malfunction
Date Received
February 28, 2013
Date of Event
December 1, 2012
Report Date
December 17, 2012
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915523
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE REPORTED CONDITION WAS CONFIRMED, DURING ON-SITE SAMPLE SERVICE, AS AN F-94 ALARM. THE ROOT CAUSE WAS DETERMINED TO BE DEFECTIVE BATTERIES. THE BATTERIES WERE REPLACED TO CORRECT THE REPORTED CONDITION.

Description of Event or Problem · 1

IT WAS REPORTED TO BAXTER (B)(4) THAT A FLOGARD INFUSION PUMP WOULD "ONLY TURN ON 1 CHANNEL". IT IS UNKNOWN WHEN THIS CONDITION OCCURRED. THERE WAS NO REPORT OF PATIENT INVOLVEMENT; THEREFORE, NO REPORT OF PATIENT INJURY, MEDICAL INTERVENTION, NOR ADVERSE REACTION IS ASSOCIATED WITH THE REPORTED CONDITION. NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
86863 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1