FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 2983559 · Received February 28, 2013

Report

Report Number
1416980-2013-04962
Event Type
Malfunction
Date Received
February 28, 2013
Report Date
February 12, 2013
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). THE EXACT DATE THE EVENT OCCURED IS UNKNOWN. THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. THIS IS AN ANCILLARY SERVICE EVENT. INITIAL EVALUATION CONFIRMED THE REPORTED CONDITION. UPON COMPLETION OF BAXTER'S INVESTIGATION, IF ADDITIONAL RELEVANT INFORMATION IS OBTAINED, A FOLLOW-UP MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

DURING PRODUCT EVALUATION BY A SERVICE TECHNICIAN A FLO-GARD INFUSION PUMP WAS FOUND TO HAVE AN F-38 ALARM. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
88234 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1