FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3032138 · Received March 6, 2013

Report

Report Number
1314492-2013-00205
Event Type
Malfunction
Date Received
March 6, 2013
Date of Event
January 31, 2013
Report Date
February 8, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Removal / Correction Number
1314492-080712-002-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED AND EVALUATED BY BAXTER. THE DEVICE EVAL CONFIRMED THE #5, #6, #7, #8, AND #9 KEYS TO BE INOPERABLE CAUSED BY A FAILED KEYPAD. IT WAS OBSERVED THAT WHEN ANY REMAINING FUNCTIONAL KEYS ARE SELECTED, AN AUTOMATIC OUTPUT OF THE #6 KEY WILL OCCUR FOLLOWING THE SELECTED KEY'S FUNCTION (E.G. WHEN THE #1 KEY IS PRESSED 16 WILL BE DISPLAYED. WHEN IN ALPHABETIC MODE AND THE ABC KEY IS SELECTED, AP WILL BE DISPLAYED INTERFERING WITH THE MDL DRUG SEARCH). THE FAILED KEYPAD WAS REPLACED. BAXTER'S ENGINEERING INVESTIGATION IS IN PROGRESS. WHEN COMPLETE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PUMP KEYPAD IS INOPERABLE. THE CUSTOMER STATED THAT THE #6 KEY IS NOT FUNCTIONING. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
96697 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1