FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3040520 · Received March 11, 2013

Report

Report Number
1314492-2013-00221
Event Type
Malfunction
Date Received
March 11, 2013
Date of Event
February 1, 2013
Report Date
February 11, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS NOT RETURNED TO BAXTER FOR EVAL AND THEREFORE AN EVAL COULD NOT BE COMPLETED. IF THE DEVICE IS RETURNED, AN EVAL WILL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT AN UNK AMOUNT OF SPECTRUM PUMPS ARE ALARMING FOR UPSTREAM OCCLUSIONS, WHEN NO OCCLUSIONS ARE OBSERVED. THE CUSTOMER STATED THAT THIS OCCURS FREQUENTLY WITH D5, NORMAL SALINE, MORPHINE AND HEPARIN (PROGRAMMED AMOUNTS AND DELIVERY RATES UNK).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
102724 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1