FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3092201 · Received May 3, 2013

Report

Report Number
1416980-2013-11237
Event Type
Malfunction
Date Received
May 3, 2013
Date of Event
April 11, 2013
Report Date
April 11, 2013
Manufacturer
SHARP CORPORATION OSAKA JAPAN
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE REPORTED CONDITION OF A FLO-GARD INFUSION PUMP WITH AN F-38 FAILURE WHEN THE PUMP WAS TURNED ON WAS CONFIRMED AND REPAIRED BY BAXTER SERVICE PERSONNEL ONSITE AT THE CUSTOMER FACILITY. THE CAUSE OF THE REPORTED CONDITION WAS DETERMINED TO BE DAMAGED FORCE-SENSING RESISTORS. THE FORCE-SENSING RESISTORS WERE REPLACED TO CORRECT THIS CONDITION. SHOULD ADDITIONAL INFORMATION BE RECEIVED, A FOLLOW-UP MEDWATCH WILL BE SUBMITTED.

Description of Event or Problem · 1

THE FACILITY REPRESENTATIVE REPORTED A FLO-GARD INFUSION PUMP WITH AN F-38 FAILURE WHEN THE PUMP WAS TURNED ON. IT IS UNKNOWN WHEN, OR IN WHICH CARE AREA, THIS EVENT OCCURRED. THE FACILITY REPRESENTATIVE STATED THAT THERE WAS NO PATIENT INVOLVEMENT, PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
194400 FLOGARD PUMP, INFUSION FRN SHARP CORPORATION OSAKA JAPAN

Patients

Seq Age Sex Outcome Treatment
1