FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3071560 · Received April 22, 2013

Report

Report Number
1416980-2013-10033
Event Type
Malfunction
Date Received
April 22, 2013
Date of Event
April 5, 2013
Report Date
April 5, 2013
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915522
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. THIS IS AN ANCILLARY SERVICE EVENT. THE ROOT CAUSE OF THE F-38 ALARM WAS DETERMINED TO BE DAMAGE TO FORCE SENSING RESISTORS (FSRS). TO CORRECT THE CONDITION, THE FSRS WAS REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. IF ANY ADDITIONAL INFORMATION IS RECEIVED, A FOLLOW UP MDR WILL BE SENT.

Description of Event or Problem · 1

DURING THE 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
172208 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1