FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3062548 · Received March 18, 2013

Report

Report Number
1314492-2013-00260
Event Type
Malfunction
Date Received
March 18, 2013
Date of Event
February 1, 2013
Report Date
February 18, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RECEIVED AND EVALUATED BY BAXTER. THE EVALUATION WAS UNABLE TO CONFIRM THAT THE PUMP WOULD NOT ALARM FOR AN OCCLUSION WHEN AN OCCLUSION WAS PRESENT. REVIEW OF THE DEVICE HISTORY LOG SHOWS THAT THE PUMP ALARMED FOR AN OCCLUSION MULTIPLE TIMES. UPSTREAM OCCLUSION AND DOWNSTREAM OCCLUSION TESTS WERE PERFORMED PER THE SPECTRUM PREVENTIVE MAINTENANCE PROCEDURE WITH THE UNIT PASSING. ADDITIONALLY A FLOW RATE TEST WAS PERFORMED WITH THE DEVICE IN QUESTION, PER THE SPECTRUM PREVENTIVE MAINTENANCE PROCEDURE AND FOUND TO DELIVER WITHIN SPECIFICATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP DID NOT ALARM FOR AN OCCLUSION WHEN AN OCCLUSION WAS PRESENT (MEDICATION, PROGRAMMED AMOUNT AND DELIVERY RATE UNKNOWN).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
111637 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1